In the first three articles we discussed diagnosis, documentation of care, and constraints and problems faced by physicians and patients. A case management approach will be used to highlight important aspects of insulin secretory failure as seen in this clinical entity. A 51 year old Caucasian female presents with fatigue. Although she lost four pounds during the past month, she denies symptoms of hyperglycemia. No family history of diabetes mellitus is reported.
Additional examination is normal.
She is more than 40 years of age. She lacks symptoms of hyperglycemia. The patient is not obese. The random serum glucose level is very high, which is seen more commonly in patients with type 1 diabetes mellitus. Her response to oral agents may be inadequate.