TY - CHAP M1 - Book, Section TI - Pancreatic Hormones & Glucose-Lowering Drugs A1 - Masharani, Umesh A1 - Kroon, Lisa A2 - Katzung, Bertram G. A2 - Vanderah, Todd W. PY - 2021 T2 - Basic & Clinical Pharmacology, 15e AB - CASE STUDYA 66-year-old obese Caucasian man presented to an academic Diabetes Center for advice regarding his diabetes treatment. His diabetes was diagnosed 10 years previously on routine testing. He was initially given metformin but when he was no longer achieving his glycemic targets, the metformin was stopped and insulin treatment initiated. The patient was taking 50 units of insulin glargine and an average of 25 units of insulin aspart pre-meals. He had never seen a diabetes educator or a dietitian. He was checking his glucose levels four times a day and smoking half a pack of cigarettes a day. On examination, his weight was 132 kg (BMI 39.5), blood pressure 145/71, and signs of mild peripheral neuropathy were present. Laboratory tests noted an HbA1c value of 8.1% (normal 69 mL/min/1.73 m2, total cholesterol 128 mg/dL, triglycerides 86 mg/dL, HDL cholesterol 38 mg/dL, and LDL cholesterol 73 mg/dL (on atorvastatin 40 mg daily). How would you treat this patient? SN - PB - McGraw-Hill CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1176975962 ER -