Presentation on theme: "A lady with vomiting. A 23-year-old female student presents to her GP 5 days after returning from a ski holiday. She developed what she thought was a."— Presentation transcript:
A 23-year-old female student presents to her GP 5 days after returning from a ski holiday. She developed what she thought was a stomach upset while away, but this failed to settle and she now has increasing nausea and recurrent vomiting.
Initial management Fingerprick blood glucose in GP surgery simply reads "high" on meter.
Investigations She has arrived in the emergency assessment unit and you are the first doctor to see her. You confirm the history as above and a nurse checks a fingerprick blood glucose for you which simply reads “high” on the meter. She looks unwell and is slightly drowsy and breathing rapidly.
What tests would you arrange and what might you expect to find?
GOOD NEWS #1 onset and course of diabetic nephropathy can be ameliorated to a very significant degree by interventions #2 these interventions have their greatest impact if instituted early on in the course of the condition
- the condition is important - there is treatment - facilities for diagnosis/ treatment exist - there is a recognised early stage - there is a suitable test - the test is acceptable to the population - interveniton is cost effective #2 Screening
Lewis, E. J. et al. N Engl J Med 1993;329:1456-1462 ACE inhibitors and diabetic nephropathy Cumulative incidence in patients with DN