Melanie Johnson is a 63 year old woman who has been admitted to your surgical ward for the drainage of a Bakers Cyst. She was diagnosed with Type 2 Diabetes Mellitus (T2DM) 6 months ago, during a routine workup for surgery. She takes no specific medication for her diabetes, and has been told by her GP to ‘watch what she eats’.

Melanie Johnson is a 63 year old woman who has been admitted to your surgical ward for the drainage of a
Bakers Cyst. She was diagnosed with Type 2 Diabetes Mellitus (T2DM) 6 months ago, during a routine workup
for surgery. She takes no specific medication for her diabetes, and has been told by her GP to ‘watch what she
eats’.

She was devastated to discover her diagnosis of T2DM, as she was aware of the risks due to her family

history. She has not returned to her GP since her initial diagnosis. She has no other past medical history of

note. Melanie says tearfully “I have been trying to eat right and exercise, but I can’t walk because of the pain in

my knee and I was feeling down and eating ice cream. I have hardly eaten anything in the last week because I

am trying to lose weight and get my blood sugar down”.

Her mother and older sister were both diagnosed with T2DM in their early 50’s.

Melanie tells you she has had the Bakers Cyst for about 2 years. It has been increasing in size over the last 8

months, restricting her movements. The planned surgery is drainage followed by two follow up cortisone

injections.

On Admission at 0800 – her blood glucose level (BGL) was 22.9 mmol/L; HbA1c: 11%. She has been fasting

since midnight. She notes that she is feeling quite “stressed” about the surgery. On admission the following

were recorded:

Height: 167cm

Weight: 105kg

Blood Pressure: 140/80 mmHg

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