Case Study: Angela is a 35-year-old woman diagnosed 2 years ago, with type 2 Dia
ID: 165999 • Letter: C
Question
Case Study: Angela is a 35-year-old woman diagnosed 2 years ago, with type 2 Diabetes Mellitus. She has 3 children whose birth weights were in the range of 4.5 to 5 kgms. The children now teenagers, show no signs of diabetes, and their weights are reported to be within normal limits despite their mother's fondness for cooking. Her husband, an underpaid construction worker is slightly overweight. Approximately 6 months ago, Angela was seen with a complaint of a series of infections that lasted longer than usual during the past 2 months. At the time she was measured as a 165 cm ( 5 feet 5 inches) and 71 kg (156 lb.) Her glucose tolerance test was positive. She was seen for follow up twice during the next month, each time showing hyperglycemia and glycosuria. At the second follow up, antidiabetic medication was prescribed, and she was referred for medical nutrition therapy (MNT). Angela did not keep this appointment or her subsequent medical appointment. She was not seeing again until 1 month ago, when she arrived to the emergency department with ketoacidosis. She responded well to treatment and was placed on a 1200 kcal diet and a mixture of intermediate and rapid acting insulin given in two injections a day. Her discharge plan included a referral for a MNT consultation session and diabetes education classes.
What did Angela first appear to have Type 2 Diabetes Mellitus?
Explanation / Answer
According to the information, the patient is suffering from metabolic disorder for a long period, i.e. more than two years. She displays nearly optimum weight but shows unhealing sores along with serial infections which are not healing properly. Her state are frequently noted to be hyperglycemic with glycosuria. She also shows diabetic showck and fainted due to weakness. Further, providing an insulin therapy improved her condition to nearly normal. Though her glucose tolerance test is positive, but a false positive test might have been occured since she was already on insulin therapy.
Collectively, these diagnostic features clearly show that this patient is suffering from Type 2 Diabetes Mellitus. The fist signs of Type 2 Diabetes Mellitus in the patient were maintenance of weight due to over-eating thus increased hunger along with sequential episodes of non-healing infections.