A 36-Year-Old Man With Fatigue, Increased Thirst, and Leg Cramps

Romesh Khardori, MD, PhD

Disclosures

February 09, 2017

Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.

Background

A 36-year-old white man presents to a walk-in clinic with fatigue, increased thirst, and leg cramps for the past several months. He reports feeling warm and having cough with expectoration for the past 10 days. He was informed that he has diabetes and hypertension (blood pressure, 140/90 mm Hg) and was advised to watch his diet, lose weight, and check weekly fasting blood glucose levels. He was placed on metformin (500 mg twice daily). His fasting blood glucose level has steadily increased; 4 months prior, his glycated hemoglobin level was 8.3%. Insulin glargine (30 U at bedtime) was added to his treatment protocol. He denies any other medical problems and is a nonsmoker. He also states that he is not able to lose weight, despite his efforts.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....