Question

Consider the following scenarios: 52 yr old male; weight: 163 lbs; Height: 5`11"; BMI: 22.7. Current Meds: Metformin: 1g; Saxtagliptin: 5mg; Glucotrol XL: 10 mg. Lab results: HbA1c: 13.9. Which of the following actions should be taken?

1) Educate the patient about low carbohydrate foods to minimize glucose elevations.
2) Contact the referring physician to consider insulin therapy.
3) Emphasize meal spacing and carb consistency.
4) Negotiate a weight loss of 5 to 7.

Answer 1

In managing a type 2 diabetes patient with high HbA1c, it's crucial to teach them about low carbohydrate foods, consider insulin therapy with the physician, and emphasize meal spacing and carbohydrate consistency.

Step-by-step explanation:

When managing a patient with type 2 diabetes who is not achieving target glycemic control, as indicated by an HbA1c of 13.9, it's important to consider a combination of lifestyle modifications and medical therapy adjustments. Given the patient's BMI of 22.7 and current medication regimen, which includes Metformin, Saxtagliptin, and Glucotrol XL, several actions could be considered:

1. Educating the patient about low carbohydrate foods to minimize glucose elevations.
2. Contacting the referring physician to consider insulin therapy.
3. Emphasizing meal spacing and carb consistency.

However, since the patient's BMI is within a healthy range, negotiating a weight loss target may not be necessary. It's crucial to individualize the treatment plan based on the patient's current medication response and overall health status.