Endocrine System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"At a first glance, this case seems to be almost boringly straightforward - a middle aged lady has presented with worsening type 2 diabetes; as she is already on insulin therapy, with presumably good dietary control, upward adjustment of her dosages seems to be all that is necessary.\n\nHowever, during her evaluation, two red flags crop up - the increase in shoe size over an year, and her inability to wear her wedding ring anymore.\n\nThese symptoms are suspicious of soft tissue growth, and bring up the spectre of acromegaly; the history of carpal tunnel syndrome is compatible in this respect.\n\nExamination reveals even more red flags - coarse facies, macroglossia, acanthosis nigricans, and enlargement of her arms. She does indeed appear to have "}]}

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