You have a newly diagnosed, type 2 diabetic, 16-year-old female in your clinic. The patient is the goalie of her high school soccer team. Her BMI is 37.
Your treatment plan for the new diagnosis of type 2 diabetes – structure your plan using the format outlined in the SOAP note assignment instructions (e.g. diagnostics, therapeutics, educational, consultation/collaboration)
Citations for each of the evidence-based practice (EBP) interventions included in your plan
For each article, you cited in support of an element of the plan, provide your thoughts about the strength of the evidence presented in the article(s)
Strength of Cited Evidence
My thoughts on the strength of the evidence cited:
ADA/ISPAD Guidelines (e.g., Diagnostics, Insulin): These represent the highest level of evidence (Level A/Grade 1) as they are based on systematic reviews and consensus among world-leading experts. The strength is in their comprehensive nature, synthesizing multiple primary studies (often RCTs and large cohort studies) to create a standard of care. They are mandatory practice references.
The TODAY Study (2012 & 2009) & DPP Study (2002):
Strength: These are considered high-level, foundational evidence (Level I-II). The TODAY study was a large, multicenter Randomized Controlled Trial (RCT) specifically designed for youth T2DM, making its findings directly applicable to this patient's demographics (age and diagnosis). The DPP was a large RCT for pre-diabetes, and its demonstration of lifestyle efficacy is powerful evidence for the need for intensive intervention in her case.
Rationale for Use: Since pediatric T2DM studies are less numerous than adult T2DM studies, the TODAY study is the most critical and robust evidence for initial therapeutic choices (Metformin vs. others).
Sample Answer
This is a treatment plan for a newly diagnosed 16-year-old female with Type 2 Diabetes Mellitus (T2DM) and obesity (BMI 37), using a SOAP note structure and evidence-based practice.
Treatment Plan for New Diagnosis of T2DM
Subjective (S)
16-year-old female, high school soccer team goalie. Newly diagnosed T2DM. BMI 37 (obesity class II). Active in sports.
Objective (O)
Age: 16 years
BMI: 37 kg/m$^2$
Diagnosis: Type 2 Diabetes Mellitus (T2DM)