You are the nurse working in a family practice clinic. Joe, a 50 year old male comes into the

clinic for physical at the insistence of his wife. Joe and his wife put in many hours working in

their small business operating a restaurant. They have three teen aged children and attend

many activities their children participate in.

Joe tells you he has not had a physical in ten years. Although they do quite well in their small

business, he says they cannot afford health care insurance at this point in their lives.

Joe is six feet tall and weighs 270 pounds. His BP is 138/80; pulse 88 and regular; his lung

sounds are clear. His random glucose is 124mg/dL. He shares he sleeps about six hours a night.

Joe is getting ready to leave from the visit and tells you he remembers the doctor told him he

should loose 50 pounds if he wants to live 20 more years. He is visibly shaken and tells you he

wants to stay healthy, but needs some help in understanding what he should do. He also tells

you that he generally doesn't do something just because someone tells him he should. He

wants to know what he should do and especially "why" this is important. He wants to know

what kinds of health problems he might have if he doesn't lose the weight.

He reminds you that he doesn't have health insurance and although has enough money to pay

his bills, but also has three teenagers who are looking at going to college before long. He

remembers when he was in college and had to work full time while earning his bachelor's

degree in marketing. He wants to be able to help his children with some of their school

expenses.

He said the doctor alarmed him when he talked about diabetes, sleep apnea, high blood

pressure, heart failure and even osteoarthritis.

Imagine that both you and Joe have all the time you need and want.

Respond to all of the following questions. Please note: this is not a 'formal paper' so it is

appropriate to copy and paste the questions below into a WORD document and answer each

question individually.

Although it is not a formal paper, it is expected that your responses are supported with

evidence. Citations and professional references are required.

1) Joe asks how losing weight can reduce his risk for developing diabetes. How will you respond

from a pathophysiologic perspective in a manner Joe can understand? Remember he has a

college degree in marketing.

2) Joe asks what kinds of laboratory and other testing he would have to undergo if he would

develop diabetes in the future. How will you respond?