An obese, 58-year old male presents with mild fatigue over the past month. The nurse practitioner takes a history, performs a physical examination, and orders fasting laboratory work. Hct = 49%, TSH = 3.2, glucose = 128 mg/dL, and cholesterol = 289 mg/dL. Which of the following is the most likely diagnosis?

1. hypothyroidism
2. anemia
3. depression
4. type 2 diabetes mellitus

Answer:

An obese, 58-year old male presents with mild fatigue over the past month. Based on the results of the test for fasting blood sugar levels the following is the most likely diagnosis;

type 2 diabetes mellitus

(As the patient is obese having high blood cholesterol level and a fasting blood sugar level of 128 mg/dL, because based on evidence based practice when the fasting blood sugar level is 126 mg/dL (7 mmol/L) or higher it is an indication of diabetes. Since the patient is obese he may have developed insulin resistance leading to type 2 diabetes)

Reference;

Diabetes, 2020. https://www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-20371451