Mrs. F. is a 60 year old
woman with a 10 year history of type 2 diabetes, she has documented
nephropathy with a creatinine of 1.3 mg/dl. Her glycemic control has however
deteriorated over the 6-12 months despite maximal dosage of an glucosidase
inhibitor such as acarbose and sulfonylurea.
Her HbA1c has risen from 8.5%
to 9.6% in the last six months. You elect to discontinue the acabose /
sulphonylurea combination, your next intervention would be:
