Risks with uncontrolled Type 2 diabetes

I need help answering the questions attached regarding Type 2 diabetes. It is a case study. Thanks!
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Wallace.doc

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Hi, I hope this helps you,

1. What are the specific risks/complication to having uncontrolled Type 2 diabetes?

The patient with uncontrolled Type 2 diabetes is at risk of nephropathy, coronary artery disease (CAD), distal symmetric polyneuropathy or symptomatic autonomic neuropathy, and retinopathy (Pambianco et al., 2006). Nephropathy can complicate control of existing hypertension or cause hypertension. If diabetes is not under control, the nephropathy can lead to renal failure and death. CAD complications include myocardial infarction and death. Distal symmetry polyneuropathy includes not only numbness, tingling, painful discomfort of legs, burning sensation, and sensory loss (Archer, Watkins, Thomas, P, Sharma, & Payan, 1983). This can lead to ulcers in the foot because the patient doesn’t feel the way the shoe fits or any laceration in the foot. Retinopathy often leads to blindness (Fong et al., 2004).

1. When and how often should Mr. Wallace monitor his blood glucose?

A random A1C level should be done to decide if treatment is needed. Although the ADA 2013 guidelines recommend that self-monitoring should be used to adjust to food intake, activity, or medications to reach specific treatment goals, self-monitoring has not been proven useful to monitor blood sugars in patients that are not on insulin (O’Riordan, 2007). Only if Mr. Wallace would be using insulin then the ADA recommends self-monitoring at least prior to meals and snacks, occasionally after eating, at bedtime, before exercise or critical tasks such as driving, when low blood glucose is suspected, and after treating .