Dawn Gets Diabetes

Joe is worried about his wife Dawn who is 44 years old. Dawn hasn’t been sleeping well, as she wakes up a few times at night to go to the bathroom. She tried to restrict her fluid intake in the evening, but that hasn’t helped and she complains of being thirsty quite a bit. Dawn is concerned about her lethargy—she’s always tired and doesn’t want to go for a walk like she once used to. She finds she only has enough energy to check her email on the computer and then head to bed early in the evening.  Dawn is about 40 lbs overweight. She eats as much as usual, if not more. She has no scale at home and cannot estimate if there has been any weight loss or gain. Joe recommends that she go to the doctor. With simple office tests, the physician finds glucose in Dawn’s urine and an elevated capillary blood glucose level. He orders a fasting blood glucose level which comes back as 14 mmol/L and a HbA1c level to which comes back at 7.5.