MRCP2-1158

MRCP2-1158

A 52-year-old woman presents to the Endocrinology Clinic with recently diagnosed type II diabetes. She reports leading a healthy lifestyle and is surprised by the diagnosis. Her past medical history includes hyperlipidemia, which is managed with atorvastatin.
On examination, her blood pressure is 140/80 mmHg and her heart rate is 72 bpm. Her cardiorespiratory examination is unremarkable, although she appears to be fatigued. Her abdomen is soft and non-tender. There is mild swelling of her ankles and she reports having to loosen her shoes due to discomfort.
Investigations:

Haemoglobin (Hb) 135 g/l 120 – 160 g/l
White cell count (WCC) 6.2 × 109/l 4.0 – 11.0 × 109/l
Platelets (PLT) 250 × 109/l 150 – 400 × 109/l
Sodium (Na+) 140 mmol/l 135 – 145 mmol/l
Potassium (K+) 3.8 mmol/l 3.5 – 5.0 mmol/l
Creatinine (Cr) 90 μmol/l 50 – 120 µmol/l
Random glucose 11.5 mmol/l 3.9 – 7.1 mmol/l

Which initial investigation would be most appropriate to confirm this patient’s likely underlying diagnosis?