Question

A 38 yo male patient arrives to the medical office where you are doing your externship complaining of fatigue, and thirstiness. He stated that these symptoms started last month and are accompanied by the need to go to pee” very often, especially at night. He also mentioned that he is been craving for fast food and ice cream very much. During the physical examination you and the doctor notice that the patients BMI is 35(obesity) and that the patient has a family history of diabetes on his mother side. According to this findings please go ahead and answer the following questions.

1. According to the signs and symptoms, what medical condition do you suspect that the patient has?

2. What are the most common signs and symptoms of his medical condition?

3. What are the most common complications of the medical condition mentioned in questions # 1 and 2?

4. What is the most common cause of dead among patients with this medical condition?

5. What does FBS and GTT stand for?

6. Explain for how long do the patients must fast before you do the FBS

7. You do a FBS test on this patient and the result reads 350 mg/dl. Is it high? Is it Low? Is it normal Explain!

8. Give the numbers for Normal glucose levels, Pre-Diabetes, and Diabetes mellitus.

9. From the demonstration video that I asked you to take a look yesterday about how to measure glucose, please explain with your own words how you measure the blood glucose levels on patients using the normal random glucometer.

10. Explain what is Polydipsia, Polyphagia, and Polyuria

Answer 1

1/ I suspect the patient most probably has Diabetes mellitus of Type1 or of Type 2 variety.

2/ The classic symptoms of DM are polyuria(excessive urination), polydipsia(excessive drinking), weight loss, polyphagia(excessive eating).

3/The complications of DM can be divided into three categories

• Microvascular
• Macrovascular
• Others

A) Microvascular-

• Eye disease- Retinopathy(non proliferative/ proliferative), Diabetic macular edema
• Neuropathy- Sensory and motor ( mono and polyneuropathy), autonomic
• Nephropathy- (albuminuria and declining renal function)

B) Macrovascular-

• Coronary heart ds
• peripheral arterial ds
• cerebrovascular ds

C) Others-

• Gastrointestinal ( gastroparesis, diarrhoea )
• Genitourinary ( uropathy/sexual dysfunction)
• Dermatologic
• Infectious
• Cataracts
• Glaucoma
• Cheiroarthropathy
• Periodontal ds
• Hearing loss

4/ Cardiovascular disease could be the most common cause of death in diabetic patients.because hyperglycemia hastens the atherosclerotic event leading to greater chances of coronary artery disease , myocardial infarction , angina pectoris and sudden death

5/FBS fasting blood sugar level less than 100mg/dL(5.6mmol/L) is normal .A FBS level from 100 to 125 mg/dL is considered prediabetes and if its 126mg/dL or higher on two seperate tests you have diabetes.

GTT oral glucose tolerance test for this you fast overnight and the fasting blood sugar level is measured . Then you drink a sugary liquid and blood sugar levels are tested periodically for the next two hrs

A blood sugar level less than 140mg/dL is normal .A reading of more than 20mg/dL after two hrs indicates diabetes. A reading between 140 and 199 mg.dL indicates prediabetes.

6/ Overnight fast

7/ Fasting blood sugar level less than 100mg/dL(5.6mmol/L) is normal .A FBS level from 100 to 125 mg/dL is considered prediabetes and if its 126mg/dL or higher on two seperate tests you have diabetes. Now in this case person level is 350mg./dL it means he is having overt DM

8/Fasting blood sugar level less than 100mg/dL(5.6mmol/L) is normal .A FBS level from 100 to 125 mg/dL is considered prediabetes and if its 126mg/dL or higher on two seperate tests you have diabetes.

9/ N/A

10/ polyuria(excessive urination), polydipsia(excessive drinking), polyphagia(excessive eating)