• CDC
  • Heart Failure
  • Cardiovascular Clinical Consult
  • Adult Immunization
  • Hepatic Disease
  • Rare Disorders
  • Pediatric Immunization
  • Implementing The Topcon Ocular Telehealth Platform
  • Weight Management
  • Screening
  • Monkeypox
  • Guidelines
  • Men's Health
  • Psychiatry
  • Allergy
  • Nutrition
  • Women's Health
  • Cardiology
  • Substance Use
  • Pediatrics
  • Kidney Disease
  • Genetics
  • Complimentary & Alternative Medicine
  • Dermatology
  • Endocrinology
  • Oral Medicine
  • Otorhinolaryngologic Diseases
  • Pain
  • Gastrointestinal Disorders
  • Geriatrics
  • Infection
  • Musculoskeletal Disorders
  • Obesity
  • Rheumatology
  • Technology
  • Cancer
  • Nephrology
  • Anemia
  • Neurology
  • Pulmonology

Diabetes Quiz: A 79-Year-Old With Elevated AlC Who Has Had a Stroke: How Would You Treat?

Article

The elderly patient has had type 2 diabetes for 15 years is now home bound after a stroke. Her HbA1c is 9.6 and she takes only metformin. Review the rest of her laboratory results and propose a management plan.

Sue Jones, 79-years-old, has had type 2 diabetes for 15 years. She is home-bound after a recent stroke and now requires assistance with most of her activities. She has a daytime sitter and a weekly visiting nurse; her family provides care in the evenings and on weekends. The family has moderate means and would like to keep her at home. Sue can communicate effectively: she recognizes all of her family members and you, as her physician.

Her most recent lab tests showed an HbA1c of 9.6; a random blood sugar of 450; triglycerides, 350 mg/dL; HDL, 40; LDL, 110 (calculated); total cholesterol, 220; and non-HDL,180.

Some of her medications were stopped when she was discharged from the hospital 3 weeks ago. She now only takes metformin (2000 mg/d) for her diabetes and no medications for her lipids.

Would you consider more aggressive treatment of her elevated HbA1c? If so, why-and with what medications? What goals would you have for her A1C? Would you do anything to treat her lipids?

Please add your comments below-including your agreements and disagreements.Dr. Shahady he will respond to the comments made within the next 2 weeks.
Click here for Dr. Shahady’s discussion of options.

Related Videos
New Research Amplifies Impact of Social Determinants of Health on Cardiometabolic Measures Over Time
Where Should SGLT-2 Inhibitor Therapy Begin? Thoughts from Drs Mikhail Kosiborod and Neil Skolnik
© 2024 MJH Life Sciences

All rights reserved.