QuestionSBA
QuestionChoice
Reassurance and discharge are not appropriate in this setting. This patient has presented with an abnormal fasting blood glucose result (>7.0 mmol/L) which requires follow-up before a diagnosis of T2DM can be confirmed or excluded.
10000423
c
Reassure and discharge
QuestionChoice
Although this patient requires additional investigation before a diagnosis of T2DM can be made, NICE recommend the use of the original abnormal test. In this case, it is therefore recommended to perform an additional fasting blood glucose test.
10000424
d
Arrange follow-up HbA1c testing in 2 weeks
QuestionChoice
As this patient has presented without symptoms and only one abnormal blood test has been produced, NICE state it is inappropriate to diagnose T2DM in this patient. In asymptomatic patients, two abnormal blood tests are required. In symptomatic patients, only one abnormal blood test is required.
10000422
b
Diagnose type 2 diabetes mellitus and discuss treatment options
QuestionChoice
NICE recommend that type 2 diabetes mellitus (T2DM) should not be diagnosed in asymptomatic patients based on a single abnormal test. Diagnosis of T2DM requires either presence of symptoms and one abnormal test (i.e. random blood glucose, fasting blood glucose, HbA1c), or two abnormal tests if asymptomatic. This patient has presented asymptomatically and therefore requires an additional abnormal test result.
10000421
a
Arrange a follow-up fasting blood glucose test in 2 weeks
QuestionChoice
Although lifestyle modification is an important aspect of T2DM management and should be discussed with all patients, it is not the most appropriate next step in this case. This patient has presented with an elevated fasting blood glucose which requires swift follow-up to confirm or eliminate a diagnosis of type 2 diabetes mellitus.
10000425
e
Provide lifestyle advice and follow up in 6 months
Concept
Chapter
2693
3761
Type 2 Diabetes Mellitus
Topic
133
Endocrinology
12631
A 51-year-old male attends a regular health check-up as part of his work. He reports no symptoms. Examination and observations are both normal, however, blood glucose testing reveals a fasting blood glucose of 8.2 mmol/L (normal range 3.5-5.5 mmol/L).

Which of the following is the most appropriate next step?
a