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Practice trajectory
-26%
JD
Dr John Dolittle
Ashford Vale Medical Group
Patients/David Okafor · SH-10291
← Practice Horizon

David Okafor

54M · SH-10291APP
Metabolic-Hepatic (pre-clinical) · Structural engineer
Next consult
Thu 16 Apr, 15:00
Gray zone· p 0.57Trending worse
Trajectory headline
Crosses T2DM diagnostic criteria within ~24 months on current trajectory. Reversible now.
Model priority
Gray zone · pattern emerging
Biggest single change you could makeAdd GLP-1 → −98% (BMI)
Patient Context Card · AIME

Brief

Trajectory-grounded orientation for today's appointment.

Fasting labs look normal. Trajectory does not. Pre-clinical metabolic window — reversible with intervention now.

Trajectory narrative

David's standard labs would not trigger concern on a traditional review — fasting glucose and HbA1c are borderline, BMI is high but stable. The Horizon-1 trajectory tells a different story: continuous glucose data from his wearable shows sustained post-prandial excursions >9 mmol/L, ALT is drifting upward, and the joint projection indicates crossing T2DM diagnostic criteria within roughly 24 months on this trajectory. This is the window to intervene.

Active concerns
  • Post-prandial hyperglycaemia (wearable-observed)
  • ALT 58 U/L trending up (may reflect MASLD)
  • Triglycerides 2.4 mmol/L
  • Central adiposity — waist 108 cm
Suggested consultation focus
  • Share trajectory visually — framing as reversible pre-diabetes
  • Order FIB-4 + OGTT to resolve gray zone
  • Structured lifestyle programme (dietitian referral)
  • Discuss weight management options including GLP-1 if lifestyle insufficient at 6 months
Supporting record context
Current medications
Nil regular
Allergies
NKDA
Family history
Father T2DM diagnosed age 58; mother alive, well
Last full bloods
2026-03-28 — fasting glucose 6.1, HbA1c 42, ALT 58
For demonstration purposes. Not a diagnostic tool.
Horizon-1 · Syndrome activation

Latent clinical states

Output of the dynamic hypergraph. Direction = trajectory on that axis.

Metabolic (pre-clinical)
0.68
Hepatic steatotic
0.61
Atherosclerotic (emerging)
0.38
For demonstration purposes. Not a diagnostic tool.