1. Diabetes Inability of pancreas to produce sufficient insulin to allow glucose to pass through cell membranes resulting in loss of cellular energy production. 61 yo female

2. Diabetes - SOAPIER S – tired, thirsty, hungry, up to BR 4-6 times each night O – Wt loss of 45 lbs in past 2 months FBS – 365, GTT – abnormal, pale urine (SG – 1.00) A – Insulin dependent diabetes mellitus

3. Diabetes - SOAPIER P: –2000 cal ADA diet (Consult Nutritionist), –Foot care instructions, –NPH Insulin U-100 30u q 7 AM, –Reg Insulin U-10 sliding scale: BS 200-250 – 2u BS 250-300 – 4u BS >300 – call office STAT

4. Diabetes - SOAPIER I – Patient Education: –ADA diet (Composition, 3 meals, 3 snacks) –Foot care (Comfortable shoes – wear at all times, daily inspection, clean & dry), nails trimmed by Podiatrist

5. Diabetes - SOAPIER I: - Insulin types: NPH, Regular Measurement Injection technique Site care – Insulin shock (Symptoms, treatment) – Diabetic Coma (Symptoms, treatment) – Recheck in 1 month or PRN

6. Diabetes - SOAPIER E – Check up at 1 month: –Normal BS –Small lesion left 5 th toe (Shoes too tight) –Weight loss – 2 lbs R – Reteach importance of shoe fit, recheck in 1 week R – Document at every visit.