A 52-year-old man with central obesity, hypertension, and acanthosis nigricans presents with polyuria and polydipsia. Vital signs show BP 148/92 mmHg, HR 88/min, RR 16/min, temperature 37°C, and SpO2 98% on room air. Laboratory studies reveal hemoglobin A1c of 9.2% and fasting glucose of 256 mg/dL. Urinalysis shows no ketones. Early in the course of his disease, which of the following laboratory findings is most likely?

  1. A)Absent C peptide due to autoimmune beta cell destruction
  2. B)High anti glutamic acid decarboxylase antibodies and low insulin
  3. C)Low glucagon due to alpha cell failure
  4. D)Severe ketonemia due to absolute insulin deficiency
  5. E)Elevated C peptide with peripheral insulin resistanceGABARITO

Explicação

Type 2 diabetes begins with peripheral insulin resistance, especially in muscle and liver, and the pancreas initially compensates by secreting more insulin. Therefore endogenous insulin and C peptide are often elevated early in disease. Obesity and acanthosis ... Ver explicação completa e trilha adaptativa →

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