Diabetes & Primary Care’s series of interactive case studies is aimed at all healthcare professionals in primary and community care who would like to broaden their understanding of diabetes.
This scenario covers fatty liver disease, including its causes, diagnosis and management.
The format uses typical clinical scenarios as tools for learning. Information is provided in short sections, with most ending in a question to answer before moving on to the next section.
Working through the case studies will improve our knowledge and problem-solving skills in diabetes care by encouraging us to make evidence-based decisions in the context of individual cases.
Readers are invited to respond to the questions by typing in their answers. In this way, we are actively involved in the learning process, which is hopefully a much more effective way to learn.
By actively engaging with these case histories, readers will feel more confident and empowered to manage such presentations effectively in the future.
Meet Clare
Clare is a 53-year-old lady with a 4-year history of type 2 diabetes. She attends her practice diabetes clinic with the following results:
- BMI 31.2 kg/m2.
- Blood pressure 144/78 mmHg.
- HbA1c 52 mmol/mol (6.9%).
- eGFR 73 mL/min/1.73 m2.
- Total cholesterol 5.6 mmol/L; non-HDL cholesterol 4.6 mmol/L.
- Alanine aminotransferase (ALT) 83 IU/L (normal range 0–45 IU/L).
- Alkaline phosphatase (ALP) 103 IU/L (normal range 40–130 IU/L).
- Gamma-glutamyl transpeptidase (GGT) 81 IU/L (normal range 0–75 IU/L).
- Bilirubin 16 IU/L (normal range 0–21 IU/L).
- Albumin 42 g/L (normal range 35–50 g/L).
- Non-smoker; alcohol 4–8 units/week.
What is the most likely cause of Clare’s elevated liver function tests?
By working through this interactive case study, we will review fatty liver disease, including its causes, diagnosis and management.
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