Susan H is a 20 year old
woman with a 5-year history of type 1 diabetes. Her diabetic control was
fairly erratic while she was a teenager but she seems to be taking better care
of herself now. She is seen in the intensive diabetes clinic and is
considering an insulin pump. She sees you for a possible urinary tract
infection.
Her blood pressure is noted
to be 142/88mmHg. and you note that her blood pressure was elevated on her
last 3-4 visits. After treating her UTI and working up her hypertension she is
found to have microalbuminuria. You begin treatment of her hypertension with
an Ace-inhibitor.
Susan achieves good control
on an ACE-inhibitor. You see her 6 months later and she tells you that she is
trying to get pregnant. Her pregnancy test is negative. You recommend:
