Is Mr. Bryan at risk of suffering from diabetes mellitus? Why? How many types of

Question

Is Mr. Bryan at risk of suffering from diabetes mellitus? Why? How many types of diabetes mellitus are there? What are the differences between them?

Personal Information

Name: Mr. Elliot Bryan

Age: 29 years old

Gender: Male

Description

Mr. Bryan is a 29-year-old married man who came to the medical office because, over the last three years, he has progressively increased the size of his shoes, and he has resized his wedding ring three times. He says his feet and hands have grown. He has also noticed that his face has turned coarse. He was a very active man and practiced sports, but now he fatigues just by walking, and feels weakness in his muscles and stiffness in his joints. He is depressed because in the last few months he has been experiencing erectile dysfunction, which is affecting his relationship with his wife. He feels he is losing his vision as well.

Mr. Bryan does not drink alcohol, smoke, or use any recreational drug. His mother suffers from diabetes mellitus type II, and his father suffers from hypertension.

On physical examination we found:

Remarkable Signs on Physical Exam by Regions

Head: Enlarged and coarsened facial features, prominent superciliary arches, prognathism

Neck: Thyroid is visible and palpable

Thorax: Barrel appearance

Abdomen: Hepatomegaly. Splenomegaly.

SOMA: Enlargement of the hands and feet. Generalized arthralgia.

Remarkable Signs on Physical Exam by Systems

Integumentary system: Thick and oily skin. Numerous acrochorda disseminated throughout the body.

Cardiovascular system: Blood pressure 150/100. Radial pulse 72.

Digestive system: Megaloglossia. Diastema.

Lab Tests

Complete blood count (CBC)

GH measurement

IGF-I measurement

Growth hormone suppression test

Glucose level

Brain MRI

Abdominal CT scan

Echocardiogram

Diagnosis

Acromegaly

Explanation / Answer

1. Mr Bryan is not suffering from diabetes mellitus because the mentioned signs and symptoms are not of diabetes mellitus. These are the signs and symptoms of acromegaly.Acromegaly is disease in which the pituitary gland produces large amount of growth hormones and cause bones grow in size especially of hands , feet and face.It affects the middle age group people.

The signs and symptoms of diabetes mellitus are:-

Polyuria, polydipsia, polyphagia these are the important characteristics of diabetes.

Fatigue, weakness,vision changes,tingling and numbness in hands, and feet, dry skin, wound that are slow to heal, recurrent infection. Mr Bryan has no characteristics features of diabetes

2.There are two types of diabetes mellitus:-

1. Type 1- It is caused by destruction of the beta cells of pancreas due to genetic , immunologic, environmental factors etc.This type is known as insulin dependent diabetes mellitus because in this there are no sufficient production of insulin. About 5%-10% people are affected by this and insulin is the core treatment of this type of diabetes.

2. Type 2- It is caused by decreased sensitivity to insulin and is known as non -insulin dependent diabetes mellitus. 90%-95%of people are affected by this and they are firstly treated with diet modification, exercise, weight loss etc and if not successful then oral hypoglycemic agents are started.

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