Maria is a 34-year-old woman with who presents to a healthcareprovider to establish primary care and management of her diabetes.She was diagnosed with type 2 diabetes 3 years ago, and has ahistory of polycystic ovary syndrome and hypertension. She works asa pharmacy technician at a local pharmacy chain and has beenmarried for 1 year. She lives with her husband and recently movedto the area from across the country for better job opportunities.Her A1C 1 year. ago was at the recommended goal of 7.0%. Hercurrent medications include metformin ER 2000 mg daily, enalapril10 mg daily, and a prenatal vitamin daily. She has no allergies anddoes not smoke or drink alcohol. She has been checking his glucoselevels at home once daily, and readings vary from 110 to 165 mg/dL.She walks for 30 minutes 2 days a week (her days off), as she feelsshe is on her feet enough when she is at work. She would also likea referral to obstetrics/gynecology, as she and her husband want tostart a family in the coming year and are not using anycontraception. Vital signs are as follows: weight, 72.5 kg; height,63 in.; body mass index, 29.5; temperature, 98.4°F; pulse, 84beats/min; respiratory rate, 20 breaths/min; and blood pressure,140/82 mm Hg.Lab results are as follows: A1C, 7.6%; glucose, 155mg/dL; sodium, 135; blood urea nitrogen, 19; creatinine, 0.8; totalcholesterol, 186 mg/dL; triglycerides, 186 mg/dL; HDL, 44; andLDL,104.
. 1What is your overall assessment of Marla’s current diabetesmanagement status?
2. What considerations should be made regarding Marla’s desire toget pregnant?
3. How should Marla focus her self-management activities prior tobecoming pregnant?
