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You are a doctor and a person walks into your clinic complaining of headaches an

ID: 259985 • Letter: Y

Question

You are a doctor and a person walks into your clinic complaining of headaches and feeling badly every time they eat sugary things. You do some bloodwork and see that they have normal concentrations of insulin but their blood sugar is still extremely high. You diagnose them with diabetes. In your answer below explain what type of diabetes the patient has, why their sugars are high despite the presence of insulin, and four possible ways the patient could lower their blood sugar with an explanation of the mechanism behind each possible solution.

Explanation / Answer

It is type 2 diabetis. Insulin resistance is there. Eventhough pancreas makes extra insulin to make up for it. But, over time it isn't able to keep up and can't make enough insulin to keep your blood glucose at normal level. Body doesnt use the insulin properly or the body either doesn't produce enough insulin, or it resists insulin.

Symptoms

Increased thirst, frequent urination, hunger, fatigue and blurred vision. In some cases, there may be no symptoms.

Diagnosis

Clinical features:

Whole body: excessive hunger, excessive thirst, or fatigue

weight gain or weight loss

common: frequent urination, blurred vision, or poor wound healing

Testes: Glycated haemoglobin test( A1C)

Random blood sugar

Fasting blood sugar

Oral glucose tolerence test

Treatments

diet: Fruits vegetables wholegrains having low glycemic index will be beneficial

exercise: physical activity lowers blood sugar. Need aerobic excercise.

medication:medications are best depends on many factors, Metformin, Meglitinides, sulphonylureas etc

insulin therapy: insulin is injected

eg: Insulin glulisine (Apidra)

Insulin lispro (Humalog)

Insulin aspart (Novolog)

Insulin glargine (Lantus)

Insulin detemir (Levemir)

Insulin isophane