Case Report of Lifestyle Management of a Complex Patient With Type 2 Diabetes Mellitus, Hypertension, and Multiple Co-Morbidities

2型糖尿病、高血压及多种合并症复杂患者的生活方式管理病例报告

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Abstract

Objective: This case report depicts the application of lifestyle medicine to an adult, non-Hispanic, African American patient in their late 40s, with poorly controlled hypertension and associated co-morbidities of obesity, Type 2 diabetes mellitus (T2DM), depression and multiple degenerative joint disease (DJD). The patient was managed via telehealth for 1 year. Background: Chronic diseases are major risks to population health. Among these, diabetes, obesity, and hypertension are the most prevalent. United States (U.S.) prevalence estimates 34.2 million (10.5%) people of all ages are diagnosed diabetes cases and 7.3 million (2.8%) adults met diagnostic criteria but are but are not formally diagnosed. As such, diabetes ranked eighth for U.S all-cause mortality. The incidence of diabetes varied across the country from 1.2 to 46.2 per 1000 persons in 2016. Among these, 89.0% were overweight or obese, 38.0% were physically inactive and 68.4% were reported with a blood pressure of 140/90 mmHg or above. In 2017, the total cost of diagnosed diabetes was calculated at 327 billion dollars. In 2019, Hypertension (HTN) was reported as a primary or contributing cause in more than half a million deaths in the U.S. In the U.S. the HTN prevalence is 47%, or 116 million. Blood pressure (BP) control is higher among non-Hispanic white adults (32%) than non-Hispanic black adults (25%), non-Hispanic Asian adults (19%), or Hispanic adults (25%). Obesity is a modifiable risk factor for cardiometabolic disease. This especially appears true with less active to non-active lifestyles of this modern century where people tend to eat more easily accessible, unhealthy and processed food. Pandemic isolation has further enhanced people's sedentary lifestyle. An answer for many of these issues is behavioral lifestyle modification. Lifestyle management is a flexible and a multi-focused approach program based on detecting individual health risks, barriers, and goal development through motivational interviewing and clinical coaching.

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