Question

A patient comes in for a follow up after being diagnosed with type 2 diabetes

after 5 years the patient lived in a different city and had a diet that she did well with for 3 years with a 10% weight loss. the downfall is that in the last 2 years, being consistent with program had been a struggle for the patient due be a caregiver for her ill mother. she now has gained weight

On physical exam her BMI is now 34 kg/m2
BP = 155/88
Lungs are clear
No peripheral edema
Abdominal exam is normal
Random blood glucose is 335 mg/dL
Urine is positive for glucose

question 1.

At this point what is the leading hypothesis? (explain your answer)

What tests should be ordered to test your leading hypothesis?

Based on your what present or future complications does the physician should to be concerned about?

Answer 1

The patient who had control of Diabetic mellitus over past three years through diet control,now presented with Obesity(BMI-34kg/m2),Hypertension (155/88) and glycosuria (Urine positive for Glucose) since the Diet was not under control for past 2 Years.

since the diet is not followed the patient devoloped Obesity.obesity Along with Diabetes mellitus is prone to cause several Complications.Here since the Blood glucose level raised very much it enters the urine to Cause Glycosuria and lead to complications like Kidney Failure in the late stages.

Also the patient have Hypertension,this is because the diabetes can cause damage to Arteries and Atherosclerosis which increase Blood Pressure And Lead to complications such as Heart attack(Myocardial Infarction)

Investigations (Test)

1.Angiography -It is an imaging test that uses X-rays to view your body's blood vessels.This is done to look for any Atherosclerosis or Hardening of Blood vessel

2.A Doppler ultrasound-It is a test that uses high-frequency sound waves to measure the amount of blood flow through your arteries and veins.

3Renal Function Test-To look for Creatinine Value (normal 0.7-1.4).Increase in the creatinine is suggestive of Kidney Failure.

Complications that are Concerned are

1.Heart And Blood vessel Problems like Atherosclerosis, Myocardial Infarction,Heart Failure

2.Diabetic Nephropathy ,Kidney Failure

Also

Diabetic Neuropathy,Diabetic Retinopathy etc should be Evaluated

Delayed Healing,Hearing Impairment are some other Complications