Case Study 76
Case Study 76
1. * Fasting glucose: 184 mg/dL-above 99 mg/dL suspected diabetes mellitus among other etiologies * HbA1C: 8.8%-The American College of Endocrinology recommends and A1C less than 6.5%. An A1C of 8.8% would also indicate diabetes mellitus. * Total cholesterol: 256 mg/dL-total cholesterol above 200 mg/dL could indicate uncontrolled diabetes * Triglycerides: 346 mg/dL-levels above 150 indicate diabetes mellitus * LDL: 155 mg/dL-Increased levels of LDL indicates metabolic syndrome and increased risk of diabetes mellitus * HDL: 32 mg/dL- Decreased levels of HDL indicates metabolic syndrome and increased risk of diabetes mellitus * UA: +glucose, -ketones- glucose represents diabetes mellitus
2. Three methods for diagnosing DM.
1. Fasting plasma glucose ≥126 mg/dl 2. Symptoms of hyperglycemia and a casual plasma glucose ≥200 mg/dl. 3. 2 hour plasma glucose ≥200 mg/dl during an OGTT.
3. Three function of insulin.
* Allows cells to use glucose for energy. * Stimulates lipogenesis * Stimulates growth
4. Describe major pathophysiologic difference between type 1 and type 2 DM.
Type 1: Immune-mediated disease. The body’s own T cells attack and destroy pancreatic beta cells. There is a virtual absence of endogenous insulin.
Type 2: The pancreas usually continues to produce some endogenous insulin but the insulin that is produced is either insufficient for the needs of the body or is poorly utilized by the tissues, or both.
5. Risk factors for type 2 DM? Place a star or asterisk next to those that Y.L. exhibits.
* Weight * * Fat distribution * * Inactivity * Family history * Race * * Age * Prediabetes * Gestational diabetes *
6. What is the rationale for starting Y.L. on metformin and glipizide?
Oral agents are used for type 2 DM to improve the mechanisms by which insulin and glucose are produced and used