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Blood Glucose Control

Reteach to Dispel Fear and Misunderstandings

Female, 76 years of age, type 2 diabetes, well managed, A1C 6%, on metformin 500mg daily. Patient also has well-managed hypertension, hyperlipidemia, and osteoporosis. She lives alone. Wants tighter diabetes control. Was having hypoglycemia when on 500mg twice daily. Requests, almost begs me, to increase her medication. States she’s afraid she’s going to have kidney problems.

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Denial: Numbers Don’t Lie

Woman, 64 years of age. History of Class II Obesity and hyperlipidemia. While she had obesity, her glucose levels were elevated. A1C 8.2%. She followed a lower carb meal plan, was active, took metformin and a GLP-1, a statin and an ACE-I. She lost 22% total body weight. A1C then remained in the 6-6.5% range for 3 years on this treatment plan. Over the past 8 months, due to insurance and her statement of denial that she ever really had diabetes, she stopped taking her glucose-lowering medication, statin, and ACE-I, wasn’t as strict with meal plan or activity, and stopped checking her glucose, but did not gain back her weight.

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