10 minute consultation: Newly diagnosed type 2 diabetes mellitus
A 62 year old woman has returned to you for the results of blood tests. She had attended for a well woman check up two weeks earlier and had mentioned that she was experiencing persistent fatigue. A random plasma glucose test that day showed a glucose concentration of 11.4 mmol/l, so you had arranged for her to have a fasting blood glucose test. Her fasting blood glucose was 8.5 mmol/l. She has no history of vascular disease or other serious medical conditions. Her aunt had diet controlled diabetes and died of a cerebrovascular event at the age of 68.
Diagnosis--You can make a diagnosis on the basis of random (>11.0 mmol/l) or fasting (>7.0 mmol/l) venous plasma glucose concentrations or by oral glucose tolerance testing (fig 1). Whichever method you use, a diagnosis of diabetes has serious implications and you should confirm it by repeat testing on a subsequent day.