AANP Family Nurse Practitioner (FNP) Certification ExamDiagnosisMedium
A 48-year-old male presents with a 2-week history of nocturnal polyuria (waking up multiple times to urinate), polydipsia, and fatigue. He reports a sedentary lifestyle and a family history of diabetes. His BMI is 32 kg/m². A fasting plasma glucose (FPG) is 138 mg/dL. An oral glucose tolerance test (OGTT) with a 2-hour plasma glucose is 210 mg/dL. What is the most appropriate diagnosis based on these findings?
- AType 2 Diabetes Mellitus
- BGestational Diabetes Mellitus
- CType 1 Diabetes Mellitus
- DPrediabetes
Show answer & explanationAnswer & explanation
Correct answer: A. Type 2 Diabetes Mellitus
The patient's symptoms (polyuria, polydipsia, fatigue) and risk factors (age, obesity, sedentary lifestyle, family history) are classic for Type 2 Diabetes Mellitus. His FPG of 138 mg/dL (≥126 mg/dL) and 2-hour OGTT of 210 mg/dL (≥200 mg/dL) both meet the diagnostic criteria for diabetes.
Why the other options are wrong
- B. Gestational Diabetes Mellitus occurs during pregnancy and is not applicable to a 48-year-old male.
- C. Type 1 Diabetes Mellitus typically presents in younger individuals with more acute and severe symptoms, often with ketoacidosis, and is an autoimmune condition. The patient's age and risk factors are inconsistent with T1DM.
- D. Prediabetes is defined by an FPG of 100-125 mg/dL or a 2-hour OGTT of 140-199 mg/dL. This patient's values exceed these thresholds.
Type 2 Diabetes Mellitus Diagnosis
Type 2 Diabetes Mellitus is a metabolic disorder characterized by hyperglycemia resulting from insulin resistance and/or impaired insulin secretion, diagnosed by specific blood glucose thresholds.
- Diagnostic criteria include FPG ≥126 mg/dL, 2-hour OGTT ≥200 mg/dL, or HbA1c ≥6.5%.
- Often associated with obesity, sedentary lifestyle, and family history.
- Symptoms include polyuria, polydipsia, polyphagia, fatigue.
Memory trick: Diabetes: Fasting Glucose 126+, A1c 6.5+, Glucose Tolerance 200+.