Case 4 Lab tests were performed on a 50-year-old lean Caucasian female during an

Question

Case 4

Lab tests were performed on a 50-year-old lean Caucasian female during an annual physical examination. She has no family history of type II diabetes or any history of an elevated glucose level during pregnancy.

Fasting blood glucose

120 mg/dL

Cholesterol

140 mg/dL

HDL

40 mg/dL

Triglycerides

90 mg/dL

What is the probable diagnosis of this patient?

Describe the proper follow-up for this patient

What is the preferred screening test for diabetes in non-pregnant adults?

What are the risk factors that would indicate a potential of this patient’s developing diabetes?

Fasting blood glucose

120 mg/dL

Cholesterol

140 mg/dL

HDL

40 mg/dL

Triglycerides

90 mg/dL

Explanation / Answer

1. The person is probably diagnosed to have pre-diabetes or impaired glucose tolerance, in which patient will have an abnormally high levels (110-125mg/dL) of fasting blood glucose levels as per WHO. The other parameters like cholesterol, HDL and triglycerides are within the normal range.

2. The follow up for this patient includes healthy meals which include low saturate fats, sugars and carbohydrates, as well as limited sodium and total calories. The person should have a proper physical exercise to maintain the sugar levels in the body and also reducing weight by as little as 5-10 percent may have a significant impact on the overall health.

3. There are 3 assays to screen diabetes in non-pregnant adults as per American Diabetes Association (ADA).

i. 75g oral glucose tolerance test (OGTT) in which the patient will take the fasting glucose test. Then will drink a sugary solution. Two hours after that, he will take another blood test. The results will be as indicated

ii. Fasting plasma glucose test (FPG) in which the patient won't eat for 8 hours before taking this blood test. The results will be indicated as

iii. Hemoglobin A1C (A1C) in which the blood test shows patient average blood sugar level for the past 3 to 4 months. Doctors can use it to diagnose prediabetes or diabetes or, if the patient already known to have diabetes, it helps show whether it's under control. The results are:

4. The risks factors for this patient developing diabetes include

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