Deceptive

Endocrine System


Step 1: View Clinicals

{"ops":[{"insert":"A 55 year old woman with type 2 diabetes mellitus presents for routine followup. She is accompanied by an HbA1c report, which has a value of 9.5%.\n\nHer condition was first diagnosed 5 years ago, and was initially managed with oral hypoglycemics. However, her glycemic control worsened over time, and she was changed to insulin 6 months ago. She is also on Atorvastatin and low-dose Captopril.\n\nDuring the evaluation, she casually mentions that she can no longer wear her wedding ring, as it is \u0027too tight now\u0027. Subsequent questioning reveals that she has gone up one shoe size over the last 1 year.\n\nThere is no history of headache, or changes in vision. Her surgical history is significant for right-sided carpal tunnel decompression, 4 months back.\n\nShe does not smoke, and has essentially stopped drinking since being started on insulin. She insists that she is strictly compliant with a diabetic diet, although she does not exercise much.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-095_en.png"}},{"insert":"\n"}]}

Step 2: Order Relevant Investigations

1. Serum IGF-1
2. GH Suppression Test

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