Saturday , October 21 2017
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When Binge Eating Disorder May Not Be a Disorder

Male, 72 years of age, type 2 diabetes, overweight secondary to binge eating disorder. Taking glipizide 20mg daily and metformin 1,000mg twice daily.

Hypoglycemic unawareness. Not regularly checking glucose. Recent A1C 6.8%

Recommended:

  • Stop glipizide
  • Start glimiperide 1mg, Invokana 100mg daily
  • Regular glucose monitoring, fasting, after meals and when feels like going to binge

Return visit:

  • Felt better overall
  • Binging in control
  • Glucose levels-Fastings 70 to 80’s, pre dinner 50-60s. No symptoms hypoglycemia

Plan:

  • Continue metformin and Invokana
  • Stop glimiperide
  • Continue glucose monitoring, meal and exercise plan.
  • Visit 2 weeks

Lessons Learned:

  • If/when someone is being treated for binge eating disorder, look at the whole picture.
  • If/when someone who has type 2 diabetes has hypoglycemic unawareness, use medications that don’t cause, or be very careful when using medications that cause, hypoglycemia. Teach patient to check glucose levels regularly.
  • If patient who is overweight or has obesity, assess for meds that cause hypoglycemia. Hypoglycemia can cause overeating which can cause weight gain. Again, choose options that do not cause hypoglycemia.

Anonymous

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