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Diabetes &
Primary Care

Case Studies

This series of case studies from Diabetes & Primary Care provides a programmed learning approach to type 2 diabetes. It is aimed at GPs, practice nurses and other professionals in primary care with an interest in and responsibility for diabetes.

Working through each case study will improve the participant’s knowledge and problem-solving skills in type 2 diabetes by applying evidence-based decisions (the science) in the context of individual circumstances (clinical judgement).

The format uses case histories as a tool for learning. Information is provided in short sections, with most ending in a question to lead on to the next section.

Crucially, the participant is invited to respond to the question by typing in an answer – in this way there is active involvement in the learning process, which, in my experience as a teacher, is undoubtedly the most effective way to learn.

David Morris, Specialist Doctor in Diabetes, Royal Shrewsbury Hospital; Undergraduate Clinical Tutor, Keele University; and retired GP
(November 2020)

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Antiplatelet treatment in diabetes

When are antiplatelet therapies appropriate for cardiovascular disease prevention in people with diabetes?

MODY: A strong family history of diabetes

Signs, symptoms, differential diagnosis and management of maturity-onset diabetes of the young (MODY).

Cardiovascular disease and type 2 diabetes

Primary and secondary prevention of CVD in people with type 2 diabetes.

Non-diabetic hyperglycaemia – Prediabetes

Diagnosing and managing non-diabetic hyperglycaemia

Dyslipidaemia and type 2 diabetes. Part 2: Statin-induced myalgia, secondary prevention of cardiovascular disease and using non-statin agents

Statin intolerance pathways and non-statin drugs for both primary and secondary prevention.

Dyslipidaemia and type 2 diabetes. Part 1: Primary prevention of cardiovascular disease and use of statins

Assessing cardiovascular risk and using statins for primary prevention.

Obesity and type 2 diabetes

Assessing and managing obesity in the context of type 2 diabetes.

Early-onset type 2 diabetes in adults

The clinical implications, diagnosis and management of early-onset type 2 diabetes.

Erectile dysfunction in type 2 diabetes

Geoffrey has type 2 diabetes and is seeking help for erectile dysfunction (ED). What examinations, investigations and treatments would you consider?

Gestational diabetes

Holly presents with symptoms of diabetes in pregnancy, while Nadia has a high risk of gestational diabetes. What management and support do they need?

Heart failure and type 2 diabetes

Mark and Jane present with symptoms suggestive of heart failure. How would you establish the diagnosis and which therapies would be effective?

The elderly and type 2 diabetes

Three elderly people require very different levels of care for their type 2 diabetes. How should you treat each of them appropriately?

Problems with the diabetic foot

Glenda, Sam and Proma all have established type 2 diabetes. Each presents with different foot problems. How would you interpret their symptoms?

Recognition and management of pancreatogenic (type 3c) diabetes

Sarah was diagnosed with type 2 diabetes two years ago. Recently her glycaemic control has deteriorated and she is unwell. What are the implications?

Pre-pregnancy care in diabetes

Georgia wants advice before trying for pregnancy, while Emily is determined to go ahead. Both have type 2 diabetes. What advice would you provide?

Managing type 2 diabetes during Ramadan

Aabid and Jameela both have type 2 diabetes. Should they fast during Ramadan and, if so, how can they do it safely?

Managing hypertension in diabetes – tricky cases

Winston, Lily and Mark have elevated blood pressure but, given their different case histories, how should each be treated?

Managing hypertension in diabetes – the basics

Brian is 52 years old. He has type 2 diabetes, is obese and his blood pressure was recently recorded as 167/97 mmHg.

Fatty liver disease and type 2 diabetes

Cassie, a 49-year-old with type 2 diabetes, is overweight, has hypertension and her liver function test results are elevated.

Hypoglycaemia and type 2 diabetes

Four mini-scenarios to help build your skills in managing hypoglycaemia in people with type 2 diabetes.

Steroid-induced hyperglycaemia

3 mini-case studies to take you through what it is necessary to consider in identifying and managing steroid-induced hyperglycaemia.

Making a diagnosis of type 2 diabetes

Colin, Rao and Rachael each have signs of elevated blood glucose, but how should correct diagnoses be made?

Type 2 diabetes and diabetic nephropathy

Meet Louise, a 56-year-old schoolteacher with type 2 diabetes and now showing signs of possible diabetic nephropathy.

The thin person with T2D
Meet Jim, a 47-year-old electrician diagnosed with type 2 diabetes four years ago, now presenting with elevated HbA1c.

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