© Ahmed Asbool

Diabetes Questions

(1) Treatment of diabetic ketoacidosis

(2) A 55 year old woman presents following testing at a health fair, which revealed a fasting glucose level of 10.1
mmol/L and a Body Mass Index of 29.
(A) Describe your initial approach to the investigation and management of this patient.
(B) Outline the core components of her long-term management, with reference to appropriate pharmaceutical
agents.

(3) Outline the appropriate management of a patient with increased body mass index(BMI) and fasting glucose of
7.1 mMol/L

(4) A 48 year old woman with insulin dependant diabetes (type 1) for 10 years attends the diabetic clinic for her
yearly regular check up. What are the important points in your history and examination of this patient at her
yearly check-up. In your answer describe the complications of diabetes, and the risk factors for development of
these complications. Describe what tests you may perform to augment the clinical evaluation

(5) A 48 year old woman with insulin dependent diabetes (type 1) for 10 years attends the diabetic clinic for her
yearly regular check up.
1 List the microvascular and macrovascular complications of diabetes. What are the risk factors for development of
these complications?
2 What are the important points in your history and examination of this patient at her yearly check-up?
3. This woman’s HbA1c is 9%. What is HbA1c? What advice would you give her? What % HbA1c is desirable?
Why is good glycemic control important?
4. This lady is also noted to have microalbuminuria. What is the significance of this and how will you treat it?

(6) A 60 year old woman presents to the endocrinology clinic complaining of increased sweating, thirst, polyuria
and poldipsia. She describes frequent headaches and recent onset tingling of her fingers particularly at night. She
has an oral glucose tolerance test. Time (min) Blood glucose (mmol/l) Growth hormone (mU/l)
0 5.6 12
30 13 15
60 15 22
90 14 38
120 12 26
1. What are the likely diagnoses?
2. What is the most likely cause of the growth hormone abnormality?
3. What other symptoms should be looked for in this patient?
4. How will you manage this patient?

(7) A 50 year old man with insulin dependant diabetes (type 1) for 10 years attends the diabetic clinic for his yearly
regular check up.
1 List the microvascular and macrovascular complications of diabetes. What are the risk factors for development of
these complications
2 What are the important points in your history and examination of this patient at his yearly check up?
3 This man’s HbA1c is 9%. What is HbA1c? What advice would you give this man? What % HbA1c is desirable for
this man? Why is good glycemic control important?
4 This man is also noted to have microalbuminuria. What is the significance of this and how will you treat it?
© Ahmed Asbool

(8) A 45 year old man presents with headache, visual deterioration, fatigue and notes that recently he is unable to
wear his rings. The results of his glucose tolerance tests are as follows. Time (min) Plasma glucose (mmol/L)
Growth hormone (mU/L)
0 8.9 14
30 14.2 19
60 14.9 22
90 13.6 43
120 12.6 24
1. The 2 diagnoses in this patient are linked. What are they?
2. Explain the aetiology and pathophysiology of the condition associated with the growth hormone abnormalities
3. Discuss the symptoms and signs of this condition
4. What other investigations would you perform?
5. How will you treat this patient?

(9) A 25 year old woman with type 1 diabetes mellitus presents to your clinic. She has not attended regularly over
the last number of years. Her blood pressure is 162/94 mmHg. She has a 24 hour urine protein excretion of 2g. Her
haemoglobin A1c is 10%. She has had a negative pregnancy test.
1. List 5 key components of her physical examination?
2. What is the diagnosis and what action should be taken as a result of her urine tests?
3. What advice will you give her concerning pregnancy?
Some weeks later she is brought in having been found wandering and confused. She is pale and sweating and is
quite aggressive.
4. How will you manage her acutely?
5. Once she has recovered what further points in her history will you enquire about?