Clinical Diabetes 24:185-186, 2006
© American Diabetes Association ®, Inc., 2006
The Meaning of Autoantibody Titers, Exercise, and Alcohol in a Thin 65-Year-Old Man Hospitalized for Cholangitis and Coincidental New Diabetes
Katherine Katholos Babington, MD and
Dawn E. DeWitt, MD, MSc, FACP, FRACP
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Presentation
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T.R. is a thin 65-year-old white man who was admitted for acute
choledocholithiasis and ascending cholangitis. The patient, who had not seen a
physician for many years, also had symptoms of polyuria, polydipsia, and
nocturia for 1 week before admission. While hospitalized, his blood glucose
levels were 123-223 mg/dl. His weight was 154 lb (BMI 22.1 kg/m2).
Inpatient blood pressure readings were 180-190/100-110 mmHg. He had no family
history of diabetes, took no medications except occasional nonprescription
analgesics, and exercised regularly. An eye examination 2 years previously was
normal. He had no known kidney disease, peripheral neuropathy symptoms, or
foot lesions.
Outpatient follow-up revealed random capillary blood glucose (CBG) levels
of 227 and 139 mg/dl and a hemoglobin A1c (A1C) of 6.5%. His normal
weight and regular exercise regimen suggested the possibility of type 1
diabetes. However, islet-cell antibodies (ICAs) and GAD antibodies were
negative. He also had hypercholesterolemia, with an LDL of 154 mg/dl. To avoid
having to take diabetes medications, the patient increased his exercise and
modified his diet by decreasing his carbohydrate intake.
T.R. monitored his CBG levels at home and returned to clinic after 2 weeks
with a log and graph of his results. He noticed a significant increase in . . . [Full Text of this Article]
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Copyright © 2006 by the American Diabetes Association.
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