Diabetes mellitus

A 62-year-old woman with type 2 diabetes is booked for an elective laparoscopic right hemicolectomy for a caecal cancer in one week. She will be fasting from mi…

Pre-internship · niche

A 74-year-old man with type 2 diabetes is brought to the emergency department by his wife because he has become sweaty, tremulous and muddled at home. His capil…

Pre-internship · niche

A 19-year-old woman with type 1 diabetes is on the surgical ward the evening after an appendicectomy. Two hours after her usual insulin she becomes sweaty and t…

Clinical rotations · middle twist

A 63-year-old woman with type 2 diabetes presents with two days of vomiting and upper abdominal pain, during which she has eaten almost nothing. She takes metfo…

Clinical rotations · middle twist

A 68-year-old man taking gliclazide modified release for type 2 diabetes is found drowsy with a blood glucose concentration of 2.1 mmol/L. He improves after int…

Clinical rotations · middle twist

A 24-year-old woman with type 1 diabetes presents with abdominal pain, vomiting and deep breathing. Her blood glucose concentration is 24 mmol/L, venous pH is 7…

Clinical rotations · middle twist

A 45-year-old man attends a health assessment. He has a sedentary occupation, a waist circumference of 108 cm and a first-degree relative with type 2 diabetes,…

Clinical rotations · middle twist

A 63-year-old woman with type 2 diabetes accidentally injects 60 units of insulin glargine instead of her usual 20 units. She becomes confused with a capillary…

Clinical rotations · common

A 28-year-old man with type 1 diabetes uses a continuous subcutaneous insulin infusion. He develops nausea after the pump gives an occlusion alarm; his blood gl…

Clinical rotations · common

A 74-year-old man with type 2 diabetes presents with several days of lethargy and increasing confusion. His blood glucose concentration is 42 mmol/L, calculated…

Pre-internship · common

A 31-year-old woman with type 1 diabetes is being treated for diabetic ketoacidosis with intravenous insulin and 0.9% sodium chloride. Four hours later, her blo…

Clinical rotations · common

A 67-year-old woman with type 1 diabetes is admitted with community-acquired pneumonia and is not eating. She normally injects insulin glargine 24 units at nigh…

Clinical rotations · common

A 24-year-old man with type 1 diabetes presents with vomiting and abdominal pain. His blood glucose concentration is 28 mmol/L, blood ketones are 6.4 mmol/L and…

Clinical rotations · middle twist

A 24-year-old woman with type 1 diabetes on a basal-bolus insulin regimen is an inpatient awaiting elective surgery scheduled for the afternoon. Mid-morning she…

Clinical rotations · common

A 64-year-old man with type 2 diabetes has an HbA1c of 62 mmol/mol (7.8%) despite maximal-dose metformin and attention to diet and activity. He had a myocardial…

Clinical rotations · middle twist