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Hi.
Welcome to this third case
in the COPD case series.
I'm Janwillem Kocks.
I'm a general practitioner
and an assistant professor
at the Department
of General Practice
at the University Medical Center
in Groningen, the Netherlands.
And this case will be
about a COPD patient
with pre-diabetes.
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So if you've seen the other two,
you will recognize this patient.
This is the same lady,
50 years of age,
works in a community archive,
and she comes to you for
her annual review for COPD.
And she tells you
she has more difficulty,
more breathlessness
the last months in her work
because the carrying
of the boxes with stuff
in the archive
becomes more difficult.
And this lady has
an FEV1 of 74 percent
of predicted,
so mild COPD
and that sounds with
and FEV1/FVC ratio of 68 percent.
And she had a course
of antibiotics
for a lung attack
in the last month
during the out-of-hours service.
She's been smoking
for quite some time
and has a number
of pack years of 35.
And she stopped
smoking four weeks ago.
She's got BMI of 27.8
and a CCQ score of 1.8.
You'll notice that
this is all the same
for all the different cases.
And her medication
is ipratropium,
which she uses about
three times a day
for the last months at least
because of her work.
She uses that when walking
with friends as well.
What's different
compared to the other cases
is that she's got a high
morning glucose level
and she got a diabetic
nurse in your practice
because of this pre-diabetes.
And she gets
advice for her diet,
for her physical activity,
and she's trying
to reduce her weight.
