Clinical Diabetes 22:101-102, 2004
© American Diabetes Association ®, Inc., 2004
Case Study: Hemachromatosis in Type 2 Diabetes
Peter Capell, MD
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Presentation
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G.O. is a 50-year-old white man referred for help in managing his diabetes. Two years before his visit, diabetes was diagnosed during a routine exam. He was started on oral hypoglycemic agents. He initially responded to this treatment, but over the ensuing 2 years, his medication doses were slowly raised until he was on 15 mg glyburide and 2,000 mg metformin. At the time of referral, his fasting blood glucose levels were in the range of 150 mg/dl and his hemoglobin A1c (A1C) was 8%. He requested a consultation when he was advised to start on insulin therapy.
His medical history was significant for heavy alcohol intake and hepatitis B with full recovery. Family history was negative for diabetes and hemochromatosis. His review of systems was positive for joint discomfort in his hands and erectile dysfunction.
Physical exam revealed normal vital signs and no retinopathy or other signs of diabetic complications. His hand joints showed mild swelling and tenderness over the proximal interphalangeal joints, and his skin was slightly, diffusely hyperpigmented.
Lab data included a random glucose of 253 mg/dl, A1C of 7.9%, normal creatinine and electrolytes, aspartate aminotransferase (GOT) of 66 units/l (normal < 44), alanine aminotransferase . . . [Full Text of this Article]
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Commentary
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Clinical Pearls
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Copyright © 2004 by the American Diabetes Association.
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