This article originally posted 06 January, 2009 and appeared in Issue 450
Test Your Knowledge Issue 450
A 52-year-old man has had type 2 diabetes for 10 years. His most recent annual eye examination showed evidence of early diabetic retinopathy. His blood pressure is 130/82 mm Hg and hemoglobin A1C value is 7.1%. He takes neutral protamine Hagedorn (NPH) insulin, 24 U in the morning and 8 U in the evening.
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Which of the following management strategies is most appropriate at this time?
A. Continue current regimen of NPH insulin without modification
B. Continue current NPH insulin dosage and start antihypertensive therapy
C. Start more intensive glycemic therapy
D. Start more intensive glycemic therapy plus antihypertensive therapy
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