n Diabetes Lifestyle - "Did you try to lose it?" : living with diabetes

Volume 2015, Issue 2
  • ISSN :



Mornay (not his real name), a 52-year-old entrepreneur with type 2 diabetes mellitus, presented for assistance with rapid deterioration of his diabetes control over the preceding 4 weeks. Mornay had lived with diabetes for five years and was currently being managed on oral medications. He had no history of chronic complications of diabetes. Although his diabetes had been suboptimally controlled in the recent past (HbA1c 7.5 %), he was worried that both his fasting (waking) and postprandial (2-hour, post-meal) finger-prick blood glucose readings were mostly over 10 mmol/l. He had no other background medical history of note. After chatting further, he mentioned that he had lost around 10 kg weight in the last 3 months. He volunteered that he had always been overweight, with a body mass index (BMI) of between 32-35 kg/m2 ('obese' from a risk point of view) and a waist circumference of 115 cm ('Centrally obese' - a waist circumference over 94 cm in a man confers a high risk of type 2 diabetes and cardiovascular disease). He had attempted to lose weight in the past, but the recent weight loss was unintentional. Unfortunately, he did not seek medical attention for the weight loss sooner. He was convinced, as he had been counselled many times before, that the weight loss would be beneficial for his diabetes control and overall well-being. He also noted that he had a persistent cough with accompanying night sweats. There were no other symptoms to suggest hyperthyroidism, no change in his bowel habits and his most recent prostate specific antigen was normal.

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