INSTITUTIONAL CASE STUDY

 INTRODUCTION:

In this case, the patient has polycystic ovary syndrome (PCOS) and an elevated result in blood
glucose. Increased insulin levels could be a factor in developing PCOS-related metabolic issues
like inflammation. It is recognized that the two conditions are related, although it is not entirely
apparent what causes them to be related.

People who believe they are in perfect condition and do not need to spend money or time
worrying about their health may find it challenging to convince them that they need preventive
healthcare. Furthermore, as a Pharmacist, it is a challenge for us to convince every patient we
encounter, but with patience and understanding, nothing is impossible.

 PATIENT BACKGROUND:

* Patient is a 23-year old, female with a height of 5’0 and a weighs of 46kg. Fully vaccinated with
booster.

* Patient is single with one sibling (brother). Mother and Father are alive.

* The Patient is currently working at Lyceum of the Philippines- Davao, AERO as Admission Staff.
Works 8-hour duty from Monday to Friday. Sometimes work extra on Saturday
(events).

* The Patient is experiencing stress most of the time and loves to eat sweets like chocolate as
her stress reliever. (-) alcohol and tobacco/vape use. No known drug allergies/ADRs.

* The Patient has been diagnosed with polycystic ovary syndrome (PCOS) year 2018.

 MEDICATION INTERVENTION:

The patient was referred to her physician, Dr. Madis, due to her elevated result (9.9 mmoL/L)
blood glucose. I noted her last meal at 12:45 PM and the time I checked her blood glucose at
2:31 in the afternoon.
 The patient complies with her current medicines: Diane pills 35mg and the usana vitamins for
stress relief. She takes the Diane pills daily for six months straight and pauses for three months.
For her Usana vitamins, she takes them twice a day.

 INTERVENTION PROCESS:

The patient is advised to avoid too much carbohydrate and sugar-containing foods like
chocolate, maintain a healthy lifestyle, and monitor her blood glucose regularly as much as
possible, for it might correlate to her PCOS. The patient is also advised to have adequate sleep
and rest as she claims she cannot achieve 6-8 hours of sleep per day, avoiding as much stress as
possible.

For her medication, she takes the usana vitamins every morning on an empty stomach and in
the evening before bedtime. She takes the pills any time of the day, sometimes as soon as she
remembers.

 OUTCOMES:

The Patient's blood pressure is 107/71mmHg, which is also expected. The Body Mass Index is
regular (19.4), and she has an elevated blood glucose of 9.9mmoL/L (not fasting). She was
diagnosed in 2018 by her physician with polycystic ovary syndrome (PCOS). She takes Diane's
pills for her PCOS; it works by blocking the effects of androgens such as testosterone and
activating the progesterone receptor. The Patient is mentioned to be experiencing stress most
of the time because she takes usana vitamins, supporting natural processes that help the body
adapt to everyday, occasional stress.

The Patient is dealing with much stress, and she mostly craves sweets like chocolates; according
to some studies, she stated that having PCOS mostly craves food that is sweets, and maybe it
may lead to elevated blood glucose, which is her result. According to research by White (2002),
as many as 30% to 40% of women with polycystic ovary syndrome (PCOS) also have insulin
resistance. This condition leads to high glucose levels and the potential for pre-diabetes and
type 2 diabetes.
 DISCUSSION:

The patient must see her physician to assess her medicine for polycystic ovary syndrome (PCOS).
As mentioned, women with polycystic ovary syndrome (PCOS) have insulin resistance that might
lead to high glucose levels. To assess the efficacy of using an oral contraceptive, Diane-35, to
treat polycystic ovary syndrome (PCOS) because it is mostly prescribed with metformin but
based on the patient biomedical data such as height, weight, waist circumference, hip
circumference, body fat percentage and serum hormone levels which the Doctors tested.

The patient also manages the stress that she's been experiencing to not add up to her case since
blood sugar may rise due to hormones being released in response to stress. It is good that the
patient finds time to do yoga for relaxation and take usana vitamins to support the body in
adopting natural or normal processes.

 CONCLUSION:

The patient's presentation is elevated blood glucose, which may be aggravated by the patient's
polycystic ovary syndrome (PCOS) condition. Initial follow-up monitoring should occur, and
adjustments to therapy should be assessed and based on efficacy and tolerability.

In this case, I appreciate the work of a Pharmacist. Pharmacy course is a diverse and rewarding
career, with opportunities for patient care, scientific research, and innovation. Pharmacists can
work in a myriad of professional settings. As I interact with this patient, I want her to get
something from me as I counsel her about her condition and the pieces of advice that she
should follow because I have one goal: for the patient to feel better and recover as soon as
possible. She thought she was healthy, but I opened her mind to something she was unaware of.
Indeed, not all heroes wear capes; some wear uniforms.

From our medication expertise, patients benefit most from having us on their healthcare teams.
Pharmacists increase medication compliance. They are culturally competent healthcare
professionals who can successfully communicate to assess various factors that influence a
 patient's capacity to take medication. These include various topics, such as nutrition, way of life,
travel, and more.

Reference:

https://www.facebook.com/verywell. (2022). Symptoms and Screening of Insulin Resistance

With PCOS. Verywell Health. https://www.verywellhealth.com/pcos-and-insulin-resistance-
2616319#:~:text=As%20many%20as%2030%25%20to,diabetes%20and%20type
%202%20diabetes.

Diane-35. (2023). Mims.com. https://www.mims.com/philippines/drug/info/diane-35?type=full