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Rapid Progression From Pre-diabetes to Severely Ill Diabetes While Under “Expert Care”: Suggestions for Improved Screening for Disease Progression

  1. Robert K. Danish, MD and
  2. Beverly B. West, BSN, RN, CDE

    Abstract

    In Brief

    Obesity is associated with an increased risk for the development of insulin resistance and subsequent pre-diabetes and type 2 diabetes. This article reports a case of a 16-year-old obese African-American male with metabolic syndrome and pre-diabetes that progressed rapidly over 7.5 weeks while under expert care to complicated type 2 diabetes requiring intensive care management. This case points out limitations in recommended clinical monitoring and patient education that can lead to delays in the implementation of more aggressive therapies. The authors then suggest low-cost methods of screening patients at high risk for progression to pre-diabetes and type 2 diabetes.

    Footnotes

    • Robert K. Danish, MD, is an associate professor of pediatrics in the Division of Endocrinology and Metabolism, Department of Pediatrics, of the College of Medicine at the University of Tennessee Health Science Center and Le Bonheur Children's Medical Center in Memphis. Beverly B. West, BSN, RN, CDE, is a diabetes clinical case manager at Le Bonheur Children's Medical Center in Memphis, Tenn.

    | Table of Contents
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