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Thread: [Diabetes Mellitus] R.P. is a 43-year-old woman

  1. #1

    Default [Diabetes Mellitus] R.P. is a 43-year-old woman

    R.P. is a 43-year-old woman visiting a primary care clinic to obtain a routine physical examination for her new job. Her past medical history is significant for GDM. She was told during her two pregnancies (last child born 3 years ago) that she had “borderline diabetes,” which resolved each time after giving birth. Her family history is signifi- cant for type 2 diabetes (mother, maternal grandmother, older first cousin), hypertension, and CVD. She appears black and when asked identifies herself as African Ameri- can. She denies tobacco or alcohol use. She states she tries to walk 15 minutes twice a week. Physical examination is significant for moderate central obesity (5 feet 4 inches; 160 pounds; BMI, 30.2 kg/m2) and blood pressure (BP) 145/85 mm Hg. R.P. denies any symptoms of polyphagia, polyuria, or lethargy. On checking her electronic medical record, she has documented hypertension and an FPG value of 119 mg/dL, measured 2 months prior.

    What features of R.P.’s history and examination are consistent with an increased risk of developing type 2 diabetes?
    Last edited by CheneyHsiung; Sun 27th September '15 at 2:44pm.
    Clinical Pharmacy Specialist - Hematology

  2. #2

    Default Risk Factors for Type 2 Diabetes Mellitus

    History

    Family history of diabetes (first-degree relative)
    Physical inactivity
    Ethnic predisposition - African American
    Previous IFG(119 mg/dL two months ago), IGT, or A1c >=5.7%
    History of PCOS, GDM, or macrosomia
    Clinical conditions associated with insulin resistance (e.g., severe obesity and acanthuses nigricans)
    Hypertension
    Dyslipidemia
    Cardiovascular disease

    Physical Examination

    Overweight - BMI is 30.2 kg/m2
    Hypertension - 145/85 mm Hg

    PS: BMI Classification

    BMI (kg/m2) Classification[17]
    from up to
    18.5 underweight
    18.5 25.0 normal weight
    25.0 30.0 overweight
    30.0 35.0 class I obesity
    35.0 40.0 class II obesity
    40.0 class III obesity
    Clinical Pharmacy Specialist - Hematology

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