This site is intended for healthcare professionals only

Dilemmas in diagnosing and managing of type 2 diabetes

Written by: | Published:

Managing type 2 diabetes is a common practice Managing type 2 diabetes is a common part of a practice nurse’s role, but may present unexpected complications

Case history 1 – The thin person with type 2 diabetes

The problem

Karen was 41 years old and working as a travel agent. She was diagnosed with type 2 diabetes four years previously and her maintenance treatments were metformin 1g bd and atorvastatin 20 mg od for cardiovascular protection. There was no family history of diabetes. Karen was up to date with her screening appointments and there were no ongoing diabetes complications.

A blood test ahead of her diabetes review appointment in primary care revealed a marked deterioration in glycaemic control from an HbA1C of 57 mmol/mol six months previously to 85 mmol/mol. Renal function tests were satisfactory with an eGFR of 74 ml/min/1.73m2. Liver and thyroid function tests were normal and lipid profile favourable with a total cholesterol of 3.7 mmol/L and a non-HDL cholesterol of 2.3 mmol/L.

At review with the practice diabetes nurse Karen could not identify any lifestyle change to account for the worsening diabetes control. A fingerprick blood glucose reading was 15.3 mmol/L with negative blood ketone testing. Blood pressure was fine at 132/75 and body mass index steady at 23.7 kg/m2.

Please login or register to read the rest of the article and to have access to downloads and comments.

What do you think? Leave a comment below or tweet your views to @IndyNurseMag

This material is protected by MA Healthcare Ltd copyright.
See Terms and Conditions.

Read a free issue from Practice Nursing

Register to read a free issue from our sister publication, Practice Nursing.

Including articles on asthma, diabetes and more. Read your copy.


Sign up to the newsletter


Independent Nurse is the professional resource for primary care and community nurses, providing clinical articles for practice nurses and prescribers.


Subscribe to our newsletter and stay up to date with the latest nursing news.

Stay Connected

Stay social with Independent Nurse by following us on Twitter, liking us on Facebook or connecting on LinkedIn.


Need access to some of our older articles? You can view our archive, or alternatively contact us.

Contact Us

MA Healthcare Ltd.
St Jude's Church, Dulwich Road
London, SE24 0PB

Tel: +44 (0)20 7738 5454
Registered in England and Wales No. 01878373

Meet the team


Find out how to contribute to Independent Nurse here.