HYPERGLYCEMIA

HYPERGLYCEMIA: Excerpt from Algorithmic Diagnosis of Symptoms and Signs

Ask the Following Questions:

1. What is the free T ₄ ? If this is elevated, think of hyperthyroidism.
2. What is the plasma cortisol? If this is elevated, think of Cushing's syndrome.
3. What is the plasma growth hormone? If this is elevated, think of acromegaly or gigantism.
4. What is the 24-hr urine catecholamine level? If this is high, think of a pheochromocytoma.

If all of the above tests are normal, diabetes mellitus is usually the diagnosis, although some of these patients could have a glucagonoma or pancreatic disease. Certain drugs can cause a spurious hyperglycemia also.

DIAGNOSTIC WORKUP

Further workup may include a CBC, urinalysis, chemistry panel, glucose tolerance test, plasma cortisol, free T ₄ , TSH, plasma and urine catecholamines, skull x-ray, vanillylmandelic acid (VMA) , and endocrinology consult.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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