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Case Study: Diabetes Mellitus Type 2

Y.L., a 34-year-old Southern Asian woman, comes to the clinic with complaints of chronic fatigue, increased thirst, constant hunger, and frequent urination. She denies any pain, burning, or low-back pain on urination. She tells you she has a vaginal yeast infection that she has treated numerous times with over-the counter medication. She works full time as a clerk in a loan company and states she has difficulty reading numbers and reports, resulting in her making frequent mistakes. She says, “By the time I get home and make supper for my family, then put my child to bed, I am too tired to exercise.” She reports her feet hurt; they often “burn or feel like there are pins in them.” She has a history of gestational diabetes and reports that after her delivery she went back to her traditional eating pattern, which is high in carbohydrates. In reviewing Y.L.’s chart, you note she last saw the provider 6 years ago after the delivery of her last child. She has gained considerable weight; her current weight is 173 pounds. Today her blood pressure (BP) is 152/97mm Hg, and a random plasma glucose level is 291mg/dL. The provider suspects that Y.L. has developed type 2 diabetes mellitus (DM) and orders the laboratory studies shown in the chart.

Chart View Laboratory Test Results Fasting glucose 184mg/dL Hemoglobin A1c (HbA1c) 8.8% Total cholesterol 256mg/dL Triglycerides 346mg/dL Low-density lipoprotein (LDL) 155mg/dL High-density lipoprotein (HDL) 32mg/dL Urinalysis (UA) +glucose, −ketones

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