QQ-3408. Mr Peter Dunbar - Nursing – Kavita Baudh – Type 2 Diabetes Mellitus

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The Community Health Nurse

Eastern Community Health Centre

456 East Street

Centreville

22 January 2019

Dear Nurse,

Re: Mr Peter Dunbar, DOB: 18 March 1932

Mr Peter Dunbar, who was diagnosed with type 2 diabetes mellitus in September 2017 is being referred into your facility. He is shifting with his daughter near centreville, requires ongoing care and management from your service.

Post - diagnosing, low fat, low - sugar, less alcohol and exercise were recommended. Dietary requirements were managed by his wife; however, he consumed 2 - 3 glasses of wine with meals. On consecutive visits, non-compliance with diet was noted due to depression following his wife's death. In March 2018, metformin was prescribed. He started self catering. He was still non - compliant to the medication and diet. He blamed to poor memory for it; therefore, some stretegies were discussed. Education regarding importance of medication - compliance and adverse effects of missed doses was given.

In June 2018, he was admitted in City Hospital Newtown with probability of myocardial infarction. Aspirin, streptokinase infusion and ramipril 5mg daily were prescribed. Sotalol and warfarin were added after confirming the diagnosis of atrial fibrillation following an ECG. In October 2018, signs of diabetic neuropathy and poor exercise tolerance were observed. Importance of adhering with drug regimen and diabetic diet was re - discussed. Today, he visited with his daughter. She will cook for Mr Dunbar after shifting to centreville. Information regarding dietary modifications and monitoring for medication - compliance has been provided.

Based on the aforementioned circumstances, continuous observation and encouragement would be profoundly beneficial. His current medication chart has been enclosed with the letter.

In case additional information is required, please do not hesitate to contact me.

Yours faithfully,

Registered nurse Community Health Centre

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