CASE STUDY 1 A 57 year old obese man (BMI: 32kg/m 2 ), hypertensive for ten years,
with positive family history of Type 2 DM in his father, presents with a few months’
history of polyuria, polydipsia, polyphagia and easy fatiguability. A random blood
sugar measurement reveals a level of 350mg/dl (19.4mmol/L) and HbA 1c 10.2 percent.
What type of diabetes does this man have?
This patient phenotypically has classical Type 2 DM, with positive family history, obesity,
hypertension (i.e., components of the metabolic syndrome– see Chapter 16: ‘
Macroangiopathy in diabetes ’ ) and development of the disease at a relatively old age. It is
very likely that the patient has insulin resistance (owing to his obesity) and reduced secretory
ability of the b-cell relative to his level of peripheral insulin resistance (which explains why
hyperglycaemia developed). It is also very likely that the patient already has or will develop
in the future dyslipidaemia (see Chapter 23), given the frequent abnormal lipid metabolism
that accompanies poor glycaemic control in DM.
Version | 2021 |
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Authors | qwivy.com |
Pages | 7 |
Language | English |
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