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This article originally posted 09 December, 2008 and appeared in  Issue 446

Test Your Knowledge Issue 446

A 48-year-old woman who has had type 2 diabetes for 6 years is seen for her semiannual examination. She has long-term rheumatoid arthritis treated successfully with low-dosage prednisone (2.5 mg daily).

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Her blood glucose is well controlled with rosiglitazone and metformin. She asks about effective weight-loss strategies; her body mass index is 32. She consulted a dietitian and lost 1.8 kg (4 lb) in the past 2 months; however, her hemoglobin A1C value slowly increased and is now 7.2%, which she finds “frustrating.” She would like to lose more weight quickly.

Which of the following changes, if any, should be made to this patient's diabetes management plan to stabilize and then reduce the hemoglobin A1C value and to facilitate weight loss?

A. Make no additional changes to the management plan

B. Initiate a resistance-training exercise plan

C. Increase the rosiglitazone dosage

D. Add a secretagogue

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This article originally posted 09 December, 2008 and appeared in  Issue 446

Past five issues: Diabetes Clinical Mastery Series Issue 69 | Issue 611 | Issue 610 | Diabetes Clinical Mastery Series Issue 68 | Issue 609 |

 
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