Diagnosing Type II Diabetes and Choosing Medications in Patients with Obesity
A 48-year-old female presents to her primary care doctor for an annual visit. She was told she had the metabolic syndrome at her physical 1 year ago when she had a hemoglobin A1c of 6.1%, hypertension (BP of 145/90), and hypertriglyceridemia (170 mg/dl). At that time, she was told of her risk of developing type II diabetes and advised to lose weight. Over the past year, the patient has gained 12 lbs and attributes her weight gain to stress and inability to prioritize a healthy diet due to balancing her career with taking care of her children. Her diet consists of high-fat and high-carbohydrate foods with fast food in the diet several times per week including processed baked goods and sugar-sweetened beverages with lunch and dinner. She has a desk job and drives back and forth to her office with no additional structured exercise. She has a family history of obesity and type II diabetes in her maternal grandmother but reports that her parents are normal weight. She does not drink alcohol or smoke. She has two children and had diet-controlled gestational diabetes during her second pregnancy.
KeywordsType II diabetes Metabolic syndrome Glucose intolerance Elevated blood pressure Prediabetes
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