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Monthly Archives: February 2016

Treating Diabetes

What is the most important aspect in treating diabetes -- lowering blood sugars or protecting the heart? Follow the link to respond!

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Question #819

(Continued from Question #816, Question #817 and Question #818 ) Mrs. O’Doole is a 34-year-old of Irish descent. She works as a florist and is married with three children. She arrives at your clinic for her annual wellness exam. Her blood pressure is 130/84 mmHg, pulse 65, BMI 24 kg/m2 and her physical exam is notable for acne and mild hirsutism. Her only current medication is oral birth control pills. She recalls starting OCP, 15 years prior, due to irregular menses. Based upon her medical history and physical, you believe it would be prudent to screen Mrs. O’Doole for type 2 diabetes. You discuss your recommendations with her and she agrees to be tested. The lab returns a fasting plasma glucose (FBG) of 112 mg/dL. You share these results with your patient and inform her that while only mildly elevated, she has impaired fasting glucose. She was started on lifestyle modifications plus dietary modifications, and exercise for weight loss. At a follow-up appointment 6 months later, Mrs. O’Doole tells you despite good intentions, she has not been able to adhere to any meaningful lifestyle changes, in fact she has gained 5 pounds. At this time, her repeat fasting plasma glucose shows FPG 138 mg/dL. After discussing management options with her, you decide the best management would be metformin and lifestyle modifications. You discuss the benefits of lifestyle changes with Mrs. O’Doole and tell her that you are referring her to an exercise program specifically for individuals with type 2 diabetes. What schedule of exercise is recommended for patients like Mrs. O’Doole? Follow the link to answer!

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It appears that we are now looking more and more at diabetes as a cardiovascular risk factor, and our therapies and goals for diabetes care need to be targeted in that direction. In order to help make this message as clear as possible, we have focused our homerun slides and …

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