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Production Assistant, Diabetes In Control

Question #817

Mrs. O’Doole is a 34-year-old of Irish descent. She works as a florist and is married with three children. She arrives at your clinic for her annual wellness exam. Her blood pressure is 130/84 mmHg, pulse 65, BMI 24 kg/m2 and her physical exam is notable for acne and mild hirsutism. Her only current medication is oral birth control pills. She recalls starting OCP, 15 years prior, due to irregular menses. Based upon her medical history and physical, you believe it would be prudent to screen Mrs. O’Doole for type 2 diabetes. You discuss your recommendations with her and she agrees be tested. The lab returns a fasting plasma glucose (FBG) of 112 mg/dL. You share these results with your patient and inform her that, while only mildly elevated, she has impaired fasting glucose. What is the best choice for initial management of Mrs. O’Doole’s prediabetes? Follow the link to respond.

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Recently I had a patient who was referred to me due to increased glucose levels, which happens all the time. However, this patient was referred because of the recent changes in fasting glucose levels. After attending a group diabetes class, the patient seemed to be improving self care and average fasting glucoses had dropped from around 165 mg/dl to 130 mg/dl. The readings held like this for two months and then started to rise again. The patient's primary caregiver assumed that the patient was no longer doing the right things learned in the class and, after lecturing the patient on all the complications that occur because of elevated glucose, sent the patient to me for individual counseling.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #7: Epidemiology and Risk Factors for Type 1 Diabetes Mellitus Part 1 of 5

Type 1 diabetes (T1DM) is one of the most prevalent severe chronic diseases of childhood, affecting more than 170,000 children in the United States, an increase of 23% since 2001. In the US, more than 25,000 children are diagnosed annually with 1:200 children and 1:100 adults diagnosed with T1DM during the lifespan.

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