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%
- Stop glipizide
- Start glimiperide 1mg, Invokana 100mg daily
- Regular glucose monitoring, fasting, after meals and when feels like going to binge
- Felt better overall
- Binging in control
- Glucose levels-Fastings 70 to 80’s, pre dinner 50-60s. No symptoms hypoglycemia
- Continue metformin and Invokana
- Stop glimiperide
- Continue glucose monitoring, meal and exercise plan.
- Visit 2 weeks
- 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.