NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE Up All Night:

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 Type list here Tests you want to run:  Type list here 7

8 Normal Range George’s Result Fasting plasma glucose <100 mg/dL 150 mg/dL Urine glucose 0–0.8 mmol/L 1.4 mmol/L Discuss George’s test results with your group – do you know what is going on yet? Can we determine whether he could have type 1 or type 2 DM (or neither) from this information?

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10 Glucose Normal HbA1C Diabetic HbA1C Glycated HbA1C (%) Normal5.6% or less Prediabetic5.7–6.4% Diabetic6.5% or greater Source: American Diabetes Association Standards of Medical Care in Diabetes, 2015

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12 C-peptide has a much longer half- life in plasma (~30 – 35 minutes) than mature insulin (~5 minutes) Preproinsulin must be processed into mature insulin through a series of cleavage and folding steps.

13 C peptideNormal Range (ng/mL) George’s Values (ng/mL) Fasting (8–10 hr)0.4 – hr post glucose2.0 – CQ#4: Are George’s test results most consistent with type 1 DM or type 2 DM? (Discuss with your group, and be prepared to defend your choice!) A.Type 1 B.Type 2 C.There is still not enough information to make a diagnosis

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Discuss with your group, and be prepared to defend your choice! 17

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