A patient, 62 years of age, with type 2 diabetes, obese and with an intellectual disability disorder had been a patient at our clinic for over 10 years. Treatment included metformin and insulin. He met regularly with his endocrinologist and diabetes educator. He spoke often about wanting to lose weight, but continued to gain or remain weight stable over the years. When he recently came in for his three month visit, he had lost 10 pounds, and his A1C was 7.2%, which was an improvement for him. He was proud of his weight loss and lowered A1C. He told us he was eating less and doing what he had been taught to do. He mentioned he was having some intermittent "stomach aches" and bowel changes however….
Suspecting that there might be more to this patient’s condition than simple adherence would explain given his past history, a complete work up was done plus a referral to a gastroenterologist for a colonoscopy. He was diagnosed with colon cancer but is now being treated.
- Although weight loss is indicated for people who have type 2 diabetes and obesity, losing weight does not always mean better adherence to treatment.
- When a drastic change is noted, even to what seems on the outward to be positive, investigate further.
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