Type 2 diabetes is a problem of:

Choice A reason: A reduced glycosylated hemoglobin level (Hemoglobin A1C) indicates that blood sugar levels have been well-controlled over the past three months. Hemoglobin A1C is a measure of the average blood glucose levels over this period. A lower A1C level suggests that the patient has been maintaining good control of their blood sugar levels, making it an unlikely indicator of poor diabetes management. The normal range for Hemoglobin A1C is below 5.7%, while levels between 5.7% and 6.4% indicate prediabetes, and levels above 6.5% indicate diabetes.

Choice B reason: An elevated glycosylated hemoglobin level is a clear indicator that the patient has not been maintaining tight control of their blood sugar levels. Hemoglobin A1C reflects the average blood glucose levels over the past three months. If the A1C level is high, it suggests that the patient's blood sugar levels have been elevated consistently over this period. This can occur despite the patient reporting blood sugar levels within the target range during clinic visits. An elevated A1C level (greater than 6.5%) is a strong sign of inadequate diabetes management and suggests the need for adjustments in the treatment plan.

Choice C reason: A random blood sugar level of 150 mg/dL performed in the clinic provides a snapshot of the patient's blood sugar level at a single point in time. While this level is above the normal range (typically below 140 mg/dL for non-diabetics), it does not provide a comprehensive picture of the patient's overall blood sugar control. Blood sugar levels can fluctuate due to various factors, including recent meals, stress, and physical activity. Therefore, a single random blood sugar reading is not a reliable indicator of tight diabetes control.

Choice D reason: The statement that there is no method to determine whether the patient is in tight glucose control is incorrect. There are several methods to assess diabetes control, with the Hemoglobin A1C test being one of the most reliable. Additionally, frequent monitoring of blood sugar levels through self-testing and continuous glucose monitoring systems can provide valuable information about how well the patient is managing their diabetes. These methods allow healthcare providers to make informed decisions about treatment adjustments and overall diabetes management strategies.

Choice A reason: Cushing's is not related to this type of edema. Cushing's syndrome is a condition caused by prolonged exposure to high levels of cortisol, a hormone produced by the adrenal glands. It can lead to various symptoms, including weight gain, thinning skin, and high blood pressure, but it does not describe the specific characteristic of edema that leaves an indentation when pressed.

Choice B reason: Swelling is a general term that describes an increase in the size of a body part, often due to the accumulation of fluid. While edema is a type of swelling, the term "swelling" itself does not specifically refer to the characteristic of leaving an indentation upon pressure.

Choice C reason: Dependent edema occurs in areas of the body that are lower than the heart, often due to gravity. This type of edema can be seen in conditions like heart failure or prolonged immobility. However, it does not specifically refer to the characteristic of pitting, which is the ability to leave an indentation upon applying pressure.

Choice D reason: Pitting edema is the correct term for this condition. It occurs when pressure is applied to a swollen area, forcing fluid movement and leaving a visible indentation that persists for some time. Pitting edema is commonly seen in conditions such as congestive heart failure, liver disease, and deep vein thrombosis. The extent and duration of the indentation can help assess the severity of the edema.