18-Year-Old Female Presenting with Concerns About Diabetes Risk

Case at a Glance

An 18-year-old female with BMI of 33.7 presents with concerns about developing diabetes after experiencing increased thirst, dizziness, and lightheadedness. She reports poor dietary habits and sedentary lifestyle, with a recent fasting glucose level of 93 mg/dL.

Patient's Story

The patient is an 18-year-old female (height 168cm, weight 95kg) who presents with a several-week history of increased thirst, dizziness, and lightheadedness, particularly with movement. She reports poor dietary habits since the beginning of the year and maintains a sedentary lifestyle with minimal exercise. She expresses significant anxiety about developing diabetes due to lifestyle factors. Her most recent laboratory glucose level was 93 mg/dL obtained earlier in the year during routine testing ordered by her dermatologist.

Initial Assessment

The patient appears anxious about her health status. She has limited access to regular primary care, having received recent laboratory work only through specialist visits. She lacks a established relationship with a primary care physician and relies on episodic care through specialists and urgent care facilities when needed.

The Diagnostic Journey

Initial laboratory glucose of 93 mg/dL was within normal limits (reference range <100 mg/dL fasting). Patient was counseled on normal glucose parameters: fasting glucose <100 mg/dL and 2-hour postprandial glucose <140 mg/dL. Given her symptoms and risk factors, further evaluation was recommended including comprehensive metabolic panel and hemoglobin A1c testing.

Final Diagnosis

Current glucose levels within normal range. Patient counseled that symptoms may be related to lifestyle factors, dehydration, or other metabolic causes rather than diabetes at this time.

Treatment Plan

1. Establish care with primary care physician for comprehensive health assessment 2. Order hemoglobin A1c and comprehensive metabolic panel 3. Lifestyle counseling regarding diet and exercise 4. Patient education on diabetes prevention 5. Consider evaluation through walk-in clinic or urgent care if primary care access limited

Outcome and Follow-up

Patient advised to seek immediate medical attention if symptoms worsen. Scheduled for follow-up laboratory work and establishment of primary care relationship. Counseled on importance of regular preventive care and health maintenance visits.