HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Eaddy, J. A. Articles by Shah, A. Search for Related Content PubMed Articles by Eaddy, J. A. Articles by Shah, A. Social Bookmarking                What's this?

Case Study: Glucose Toxicity: Type 1 or Type 2?

The first 20% of the full text of this article appears below.

	Presentation

 
J.S. is a 39-year-old male truck driver who presented to the emergency room (ER) on a Friday night complaining of polyuria, polydipsia, and fatigue of 2 weeks' duration. He also reported a 15- to 20-lb. weight loss over the past 1-2 months. He denied any antecedent acute illness and had not been diagnosed with any chronic medical conditions. He had no known allergies and was taking no medications.

The patient's mother died at age 75 with Alzheimer's disease and alcoholic cirrhosis. His father died from prostate cancer at age 79. There was no family history of diabetes, hypertension, or heart disease. He reported smoking a half-pack of cigarettes per day, drinking 1-2 beers nightly, and bingeing with two 12 packs of beer on most weekends.

J.S. weighed 228 lb. (104 kg) and is 5'11'' in height. His BMI is, therefore, 32 kg/m². He was afebrile, and his blood pressure was 132/82 mmHg. His physical exam was remarkable only for signs of mild dehydration.

The patient's serum test results were as follows: glucose, 682 mg/dl; sodium, 131mEq/l; potassium, 3.6 mEq/l; CO₂, 25 mEq/l; creatinine, 1.4 mg/dl; ketones, negative; and hemoglobin A_1c (A1C), 11.7% His hepatic chemistries were normal. Urine ketones were 40 mg/dl, and urine glucose was > 1,000 mg/dl.

In the ER, J.S. received intravenous insulin and fluids. After 5 hours, his serum chemistries were as follows: glucose, 270 mg/dl; sodium, 137 mEq/l; potassium, 3.0 mEq/l; creatinine, 1.1 mg/dl; and CO₂, 23 mEq/l. He was discharged from the ER with a prescription for rosiglitazone, 4 mg daily, and was instructed to see his family doctor for follow up of newly diagnosed diabetes.

Three days later, at his initial family practice visit, J.S. reported improvement in his diabetes . . . [Full Text of this Article]

	Questions

 

	Commentary

 

	Clinical Pearls

 

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?