39 yr old woman with a BMI of 32.3 with recurrent thrush has gylosuria ++ and ketones+. She has no symptoms of polyuria or polydipsia. A random BM is 12.
this lady has a typical phenotype of a type II diabetic but has ketones in her urine. On closer questioning, this lady has not missed any meals recently. She has no osmotic symptoms. Should she be sent for emergency medical review or managed as a type II diabetic in the community?
after review this lady was monitored on the medical admissions unit and then sent home on oral hypoglycaemic medication. What level of fasting glucose at the time of diagnosis would prompt a clinician to starting oral hypoglycaemic medication at the time of diagnosis of type II diabetes?
an abdominal ultrasound confirmed the presence of a fatty liver. A hepatitis screen was negative. Does this lady's raised ALT have significance in terms of choice of future oral hypoglycaemic medication?