Type 2 diabetes mellitus: December 2008
DKA: July 2009 (likely due to temporary beta cell failure)
Reactive hypoglycaemia: 2011
Hyperlipidaemia
Depression / anxiety
Current smoker
December 2008: Admitted to Hospital with community acquired pneumonia. Found to have high random BMs. Did not attend for O/P OGTT or follow-up appointment
July 2009: presented to GEH with DKA, precipitated by shoulder abscess (Blood gas: H 51.3, pCO2 2.8, HCO3 10.1, BE -14; urine ketones positive)
started on Novomix 30
history of significant weight gain in preceding 1 year (from size 12 to size 22), eating high quantities of chocolates, snacks, etc.
initial HbA1c: 12.9%, Islet cell and GAD antibodies: negative
November 2009: Was only taking 5 units of Insulin a day, tried on Metformin but intolerant to it
Insulin discontinued, tried Sitagliptin
Laura admitted to being obsessive with regards to BM monitoring (checking >20 times per day and drinking Lucozade if BMs fell to < 10 mmol/l)
August – December 2010: stopped taking all oral hypoglycaemic agents in October 2010
HBA1c: 5.7%
lost significant amount of weight
May 2011: Recurrent hypoglycaemic episodes x 1/12 history (BMs down to 2.2, associated with shakes, sweats and collapses
tended to occur after lunchtime or eating
Short synacthen test: normal (cortisol 330 to 694), TSH 2.74, fT4 15.2, LFTs and U+Es normal
June 2011: Admitted for 72 hour fast
lowest lab glucose: 3.3, therefore insulin / C-peptide levels not done
no collapses or aobvementioned symptoms of hypoglycaemia noted
July 2011: Diagnosis of reactive hypoglycaemia made
tried on Acarbose 50mg BD but Laura stopped it after 2 weeks due to side-effects
Referred to dietician for low GI diet but Laura did not find it particularly useful
August 2011: Seen in clinic and diagnosis of reactive hypoglycaemia explained again
Laura and mother concerned about disabling nature of symptoms and have requested second opinion
some one must no of a hospital that will be able to help me plzzz
DKA: July 2009 (likely due to temporary beta cell failure)
Reactive hypoglycaemia: 2011
Hyperlipidaemia
Depression / anxiety
Current smoker
December 2008: Admitted to Hospital with community acquired pneumonia. Found to have high random BMs. Did not attend for O/P OGTT or follow-up appointment
July 2009: presented to GEH with DKA, precipitated by shoulder abscess (Blood gas: H 51.3, pCO2 2.8, HCO3 10.1, BE -14; urine ketones positive)
started on Novomix 30
history of significant weight gain in preceding 1 year (from size 12 to size 22), eating high quantities of chocolates, snacks, etc.
initial HbA1c: 12.9%, Islet cell and GAD antibodies: negative
November 2009: Was only taking 5 units of Insulin a day, tried on Metformin but intolerant to it
Insulin discontinued, tried Sitagliptin
Laura admitted to being obsessive with regards to BM monitoring (checking >20 times per day and drinking Lucozade if BMs fell to < 10 mmol/l)
August – December 2010: stopped taking all oral hypoglycaemic agents in October 2010
HBA1c: 5.7%
lost significant amount of weight
May 2011: Recurrent hypoglycaemic episodes x 1/12 history (BMs down to 2.2, associated with shakes, sweats and collapses
tended to occur after lunchtime or eating
Short synacthen test: normal (cortisol 330 to 694), TSH 2.74, fT4 15.2, LFTs and U+Es normal
June 2011: Admitted for 72 hour fast
lowest lab glucose: 3.3, therefore insulin / C-peptide levels not done
no collapses or aobvementioned symptoms of hypoglycaemia noted
July 2011: Diagnosis of reactive hypoglycaemia made
tried on Acarbose 50mg BD but Laura stopped it after 2 weeks due to side-effects
Referred to dietician for low GI diet but Laura did not find it particularly useful
August 2011: Seen in clinic and diagnosis of reactive hypoglycaemia explained again
Laura and mother concerned about disabling nature of symptoms and have requested second opinion
some one must no of a hospital that will be able to help me plzzz
