Type II Diabetes Diagnosis

The pharmacologic management plan for diabetes patients.

Case Study

A 60-year-old woman with a 10-year history of Type II diabetes diagnosis presents with multiple complications including retinopathy, peripheral neuropathy, and declining renal function.

She has not had the urge to eat as recently she feels “full” after a few bites. The incidence of nausea and feeling bloated occurs at least twice a day and even after a glass of water, she feels bloated. She also complains of fatigue and not been able to keep up with daily chores.

A radiographic gastric emptying study shows a prolonged gastric emptying time.

Assignment Questions

  1. What is the typical diagnosis for a patient who presents with this clinical picture?
  2. What is the class of the drug used to treat the pathophysiology?. Discuss the pharmacologic management plan for this patient.
  3. Outline the mechanism of action and any possible contraindications of the pharmacologic management plan that you identified for the patient.




Type II Diabetes Diagnosis




Student’s Name







Type II Diabetes Diagnosis

The Pharmacologic Management Plan for Diabetes Patients

Type II diabetes is a chronic embolic disease portrayed by high blood sugar levels due to insulin confrontation and inadequate insulin production. The diagnosis of type II diabetes is situated on clinical standards like fasting plasma glucose levels, oral glucose tolerance tests, and HBA1c levels (Chivese et al., 2022). The American diabetes association advocates a fasting plasma glucose level of greater than 126 mg/dl or an HBA1c level of higher than 6.5% for the diagnosis of diabetes. A diagnosis of diabetes must be established by redoing the test on a subsequent day to highlight laboratory errors and stress, including hyperglycemia. This essay will explore a case study of a 60-year-old woman with a 10-year history of type II diabetes and evaluate the specific diagnosis for a patient with such a clinical picture, explaining the pharmacologic management plan for the patient, and the mechanism of action of the pharmacologic superintendence plan.

The Typical Diagnosis for a Patient Presenting with This Clinical Picture

From the picture presented by the patient, she is most likely to have gastroparesis, a condition leading to delayed stomach emptying because of nerve damage brought about by uncontrolled diabetes. The symptoms of gastroparesis involve feeling crammed after small meals, nausea, vomiting, bloating, abdominal pain, and weight loss (Hagopian et al., 2022). The condition can also lead to blood sugar variation, weight loss, and malnutrition. The patient’s extended gastric emptying duration evaluated by the radiographic study reinforces the diagnosis of gastroparesis. The existence of other diabetic complications like retinopathy and peripheral neuropathy is also compatible with the principal diabetes diagnosis. The patient’s fatigue and incapacity to keep up with diurnal chores may be because of malnutrition brought about by gastroparesis.

The Class of the Drug Used to Treat the Pathophysiology and the Pharmacologic Management Plan for the Patient

From the presented symptoms of the patient, it can be concluded that the patient suffers from gastroparesis, where the stomach takes too much time to empty its contents. The prolonged gastric emptying duration can be accountable for feelings of compactness, bloating, and nausea. The pharmacological management plan for the patient must be carefully considered due to her age and comorbidities. The class of drugs used to handle gastroparesis is prokinetic agents, increasing gastric motility and hastening gastric emptying. One of the used prokinetic agents is metoclopramide, which maximizes the release of acetylcholine and refines the gut to its effects (Giudicessi et al., 2018). More prokinetic agents are erythromycin, demperidone, and cisapride, where cisapride is associated with severe cardiac adverse impacts and is unavailable in most countries. Metoclopramide is appropriate for the patient in the case study, beginning at a low dose and titrating up as tolerated. The patient’s symptoms must be monitored closely, with the medication used for the shortest time possible. Additionally, the patient’s blood glucose levels require close monitoring because the drug can increase insulin production, causing hypoglycemia in diabetic patients, and the pharmacologic management plan for the gastroparesis patient entails using prokinetic agents, like metoclopramide to enhance motility and hasten gastric emptying. Due to the patient’s age, the medication must be used cautiously, monitoring potential adverse effects closely.

The Mechanism of Action and Possible Contraindications of the Pharmacologic Management Plan

The pharmacologic management plan for gastroparesis must be considered the patient’s symptoms and radiographic gastric emptying study. One approved alternative is using prokinetic agents like metoclopramide, increasing gastrointestinal motility, obstructing dopamine receptors in the brain and animating tissues to acetylcholine (Shakhatreh et al., 2019). This medication can minimize symptoms like nausea, vomiting, and bloating, and the drug also has potential side effects like tardive dyskinesia, an irreparable movement disease, and parkinsonism-such symptoms, specifically in elderly patients. The use of metoclopramide must be avoided in patients having a history of gastrointestinal blockage, bleeding, and perforation (Gök et al., 2019). The medicine’s profile and dosage must be attentively monitored in patients with renal and hepatic impairment, where a lower dose must be directed. The patient’s declining renal function is outlined, her creatinine clearance must be evaluated before initiating metoclopramide therapy. The hazards and profits of the drug should be thoroughly discussed with the patient before beginning any treatment.


A patient with symptoms like nausea, belatedness, fatigue, and reduced renal function having a history of type II diabetes may have gastroparesis. A radiographic gastric emptying study verifies the diagnosis. The pharmacologic management plan for gastropareses involves prokinetic agents like metoclopramide, enhancing gastric emptying by maximizing the tone and contractility of the stomach muscles. Metoclopramide has potential contradictions like extrapyramidal symptoms, tardive dyskinesia, and interactions with other medications. Accurate monitoring of the patient’s response and side effects is appropriate, ensuring effective treatment and reducing adverse reactions.



Chivese, T., Hirst, J., Matizanadzo, J. T., Custodio, M., Farmer, A., Norris, S., & Levitt, N. (2022). The diagnostic accuracy of HbA1c, compared to the oral glucose tolerance test, for screening for type 2 diabetes mellitus in Africa—A systematic review and meta‐analysis. Diabetic Medicine39(4), e14754. https://doi.org/10.1111/dme.14754

Giudicessi, J. R., Ackerman, M. J., & Camilleri, M. (2018). Cardiovascular safety of prokinetic agents: a focus on drug‐induced arrhythmias. Neurogastroenterology & Motility30(6), e13302. https://doi.org/10.1111/nmo.13302

Gök, A. F. K., Sönmez, R. E., Kantarcı, T. R., Bayraktar, A., Emiroğlu, S., İlhan, M., & Güloğlu, R. (2019). Discussing treatment strategies for acute mechanical intestinal obstruction caused by phytobezoar: A single-center retrospective study. Ulus Travma Acil Cerrahi Derg25(5), 503-509.

Hagopian, G. G., Johnson, K. P., Shahsavari, D., & Parkman, H. P. (2022). Meal eating characteristics of patients with gastroparesis. Digestive Diseases and Sciences67(8), 3872-3880. https://doi.org/10.1007/s10620-021-07190-0

Shakhatreh, M., Jehangir, A., Malik, Z., & Parkman, H. P. (2019). Metoclopramide for the treatment of diabetic gastroparesis. Expert Review of Gastroenterology & Hepatology13(8), 711-721. https://doi.org/10.1080/17474124.2019.1645594

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