Six months later, the patient undergoes an OGTT as a follow up to previous testi

Question

Six months later, the patient undergoes an OGTT as a follow up to previous testing. By this time he is reporting increased thirst and urination, particularly duirng the night. He returns a 2hr post glucose load blood glucose reading of 13.3mmol/L. Suggest a current diagnosis for this patient and why the symtpoms reported at this appointment might be occurring. What will a dipstick glucose indicate and why?

A37 year old man attended his GP's office for a routine pre employment physical following a long period working as a bookkeeper from home. He is Caucasian and on examination appeared in relatively good health, though reported an increase in snoring which was disrupting his sleep. His BMI was 29.4(92kg) and blood pressure was 130/85. The following biochemistry results were obtained. Plasma Urine Result 140 mmol/L 133-143 3.8 mmol/L 3.6-4.6 25 mmol/L 24-32 105 mmol/L 98-108 5.2 mmol/L 3.0-7.0 40 mmH 125 umol/L 60-120 Reference Range Result Negative Negative Reference Range Dipstick Protein Blood Albumin/Creatinine 0.010g/g

Explanation / Answer

The person must be suffering from diabetes mellitus type 2. The condition occurs due to resistance of insulin receptors to insulin. Insulin is a hypoglycemic hormone that lowers blood glucose levels. As the action of insulin is affected, there will be hyperglycemia or increased blood glucose levels. The symptoms of increased thirst and urination is due to increased glucose levels in blood. The dipstick test will also indicate the presence of glucose in urine as the rental threshold for glucose is breached.

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