Special Feature -- GLP-1 Test Your Knowledge #629: Mary Ann is a 53 year-old white female 5'6" and 197 lbs who has been diagnosed with...
Mary Ann is a 53 year-old white female 5'6" and 197 lbs who has been diagnosed with type 2 diabetes for the past 9 years.
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Due to changes in health insurance plans she is on her 4th prescriber since diagnosis and has been through a variety of diabetes medication combinations. Her A1c is currently at 7.8 and she is currently taking metformin 2000mg/day and Glipizide 10 mg bid which she started about 6 months ago. She had discontinued taking glucose levels due to the pain associated with testing.
Her new physician had her start testing one meal each day before and 2 hours after each meal and found that her glucose would increase an average of 65-70 mg/dl after each ppg reading. During the time she had been on the Glipizide she had gained 9 lbs and was seemingly hungry all the time.
She also takes, lisinopril 5mg qd, naproxen 500 bid, and Nexium 20mg qd
She was referred to a diabetes education class and had learned about carb counting and claimed that she had lowered her carbohydrates to under 160gm/ day.
On this office visit her glucose was 184 mg/dl after her meal and the prescriber decided to add a new medication.
Based on the information given the best choice would be
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