Diabetes Essay

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Dakota Diabetes Coalition is proud to offer this column on diabetes and related concerns every other Friday. Dr. Johnson is a family practice doctor in Grand Forks with a special interest in diabetes -- and a special knack for writing. As a member of the Dakota Diabetes Coalition, he has generously made himself available to answer questions through our listserv. If you have comments, or questions for Dr. Johnson to address in future columns, please contact gailhand@q.com Visit the Coalition’s website! http://www.ndhealth.gov/diabetescoalition/ Meet ‘M.G.’ Diabetes Case Study M.G. is a 58 y/o white female who presents to her primary care physician with a complaint of “tired all the time.” It’s been going on for several months, and she doesn’t report any concerns with nighttime sleep. She doesn’t note any new stress or other life changes, and denies depression or anxiety. Alcohol consumption is limited to one to two drinks per week, and she quit smoking over 10 years ago. Family history is notable for type 2 diabetes in an older sister; her mother had hypothyroidism and “heart disease.” The patient also has high cholesterol that she has been trying to treat with “weight loss and exercise.” She walks about 20 minutes three times weekly when the weather allows. She has been treated for about five years for hypertension with hydrocholorthiazide. The pertinent findings on physical exam: Height:5’4” Weight:212 lbs. BMI:36 BP:135/86 Heart/Lungs: Normal exam Abdomen: Obese and benign No thyromegaly Vision and optic fundi: normal Feet: normal Remainder unremarkable Risk factors for development of diabetes? Yes. Her risk factors include hypertension, dyslipidemia (cholesterol disease), obesity, family history of type 2 diabetes, and cigarette smoking, which is an independent risk factor for the development of type 2 diabetes. What labs would you order

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