Case-based learning (W4) DM-focus

Question 1

Mr Taylor, a 54 year old caucasian office worker, was found to have a fasting blood glucose (FBG) of 6.4 mmol/L following detection of glycosuria on a routine screen. He has no known past medical history but his brother developed type 2 diabetes in his late 40’s

Answer 1

PRE-DIABETIC/ AT RISK

An oral glucose tolerance test (OGTT) is helpful when a fasting plasma glucose result is equivocal (i.e. 6.1-6.9 mmol/L) . If fasting plasma glucose is between 5.5 and 6.0 an OGTT is also indicated.

Question 2

Should a patient on metformin be taught self monitoring?

Answer 2

not really. incorporate at sulphonylurea prescription

Self monitoring of blood glucose is not always required. Metformin carries no risk of hypoglycaemia which is usually the main indication for testing. (see NICE guideline 87 page 7). If however the patient wants to monitor and doing for a purpose they should be given the opportunity to.