Type 2 Diabetes Mellitus is a chronic illness that requires continual medical care and monitoring as well as ongoing patient education. Management and treatment of diabetes is complex and requires many issues to be addressed. Trying to manage diabetes among those incarcerated creates it’s own unique challenges. Clinicians in prison environments must take these challenges into consideration when trying to manage inmate patients with diabetes.
The American Correctional Association has created comprehensive health care standards to improve the quality of health care among prison populations. Health care providers in jails, detention centers, county and state institutions, and federal correctional facilities are all held to the same high standards of care. Correctional health care has become a specialty field of practice and offenders have the right to access care delivered by qualified health care providers (Hunsicker, 2009).
Overview of a Patient with Diabetes in the Prison Setting
Patient History and Presentation
This scholarly paper will review an incarcerated patient living with type 2 diabetes mellitus in a prison setting. G.P. is a 24-year-old Hispanic male incarcerated in a low security federal prison. He was diagnosed with type 2 diabetes mellitus at the age of 23 while incarcerated. He has no other chronic or mental health conditions.
Social History
Nutrition and Diet Habits. He has gained approximately 20 pounds since becoming incarcerated. His current work assigned at the institution is washing dishes in the Food Service Department. He states that he likes working in Food Service but often overeats and makes unhealthy food choices since he has easy access to food. He typically purchases preprocessed foods and snacks including non-diet soda from the commissary.
Exercise. The institution has a large recreational department with competitive sports programs and hobby shops. He states he does not routinely exercise or participate in any of the recreational services offered at the institution.
Sleep / Relaxation. States he sleeps approximately four to five hours every night. He has to get up at 3 a.m. to report to work in Food Service. He sometimes takes an afternoon nap. He likes to read for relaxation.
Substance Use. He has a positive history for alcohol and marijuana use but has not used drugs or alcohol for the past 10 months since being incarcerated. He used to smoke one-half a pack of cigarettes per day for approximately seven years but has quit since being incarcerated due to the prisons no smoking policy.
Social Support. His mother and father are both alive and as far as he knows neither have any chronic conditions. He has four siblings all whom are alive and presumably disease free. He has not seen or contacted either by telephone or writing any members of his family for the past six years. He is single and states that he has no social support outside of the prison walls but has several friends within the institution.
Educational Level. He dropped out of school in the ninth grade. States he never was a very good student. He got into a gang and started selling drugs at the age of 15. Since being incarcerated he is taking GED classes and hopes to earn his GED within the next six months.
Review of Systems
General. Denies fatigue, malaise, fever, chills or sweats.
Skin. No history of skin disease. Denies any changes in moles, excessive dryness or moisture, pruritis, excessive bruising, rash or lesions. No problems with toes or feet.
