Type 2 Diabetes Mellitus Case

A 27 yo Hispanic woman presents for a routine Pap smear. She has had Pap smears every 1-2 years and all have been normal, except last year's Pap which noted the presence of yeast.

Medications Over-the-counter vaginal yeast cream (3 times over the past year) for vaginal itch.
Past Medical History G2P2. Gestational diabetes mellitus (GDM) during her second pregnancy, 4 years ago.
Family History Her father, age 54, has Type 2 diabetes mellitus (DM). Her mother, age 52, has hypertension. Her 3 siblings are well.
Social History She is Mexican-American and was born in the United States. She is married and in a monogamous relationship with her husband.
ROS Fatigue, weight gain, and recurrent vaginal/vulvar itch. Otherwise negative.
Habits Smoking: none
Alcohol: none
Other drugs: none
Exam: Height 5'4", weight 174 lb. (BMI 30), BP: 136/88. Heavyset, appears fatigued. No thyromegaly. Thick white discharge present in vagina, with minimal erythema. Remainder of exam is normal. Pap smear is taken. KOH prep shows yeast forms.

Which is the single most important blood test for this patient to have done at this time?

  1. HIV 1 & 2 antibody test.
  2. Blood glucose level.
  3. High-sensitivity TSH test.
  4. Total cholesterol level.
  5. None of the above - she does not need any blood work done at this time.
Type 2 Diabetes Mellitus module

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