Type II diabetes: some problems in diagnosis and treatment.

This case is a rather typical presentation of a patient with mild, type II diabetes. His case illustrates some of the pitfalls in the dietary management of diabetes, in treating the glucose abnormality and hypertension, and in diagnosing the mental obtundation that can occur in type II disease. This patient¿s glucose abnormality can probably be treated adequately with a normal- or low-calorie diet that is appropriately high in carbohydrates and low in fats. His hypertension must be treated adequately, preferably with lower doses of diuretics or, if other drugs are necessary, one other than a beta-adrenergic blocking drug. Clearly, his cholesterol should be treated too, but the high-carbohydrate, low-fat diet now prescribed for diabetics will probably be adequate to reduce this risk factor for cardiovascular disease. Finally, the last major risk factor for cardiovascular disease, namely smoking, should unquestionably be removed.