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Question #823

Test Your Knowledge

Mrs. Hunter is a 36-year-old African-American who comes to your office for her annual wellness exam. She is overweight (BMI 27 kg/m2), but is otherwise healthy. She jokes that she “just can’t seem to lose that extra baby weight” after giving birth 3 years ago. However, her daughter recently started preschool, so she has been able to go to her new gym several times per week. In fact, one of the added bonuses of her membership is the free, weekly nutrition and exercise support groups. In addition to her routine labs, you order an A1C, which comes back elevated at 7.1%. This measurement is confirmed several days later. Based on Mrs. Hunter’s profile, what would a reasonable next step be? Select one answer: A. Encourage lifestyle modifications and start metformin with an A1C target of less than 7.0% B. Encourage lifestyle modifications and start metformin with an A1C target of less than 6.0% C. Encourage lifestyle modifications and do not initiate drug therapy at this time D. Encourage lifestyle modifications and start metformin and a sulfonylurea Are you correct? Follow the link to see!

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Don’t Look, Don’t Know

Woman, 55 years of age, type 2 diabetes for 15 years. When first diagnosed, did all she could to learn everything about managing her diabetes. She even went to two complete diabetes education courses. The second she paid for on her own. In time, she started checking less, ate more and more unfriendly diabetes foods, and due to a chronic ankle problem, became more and more inactive. After losing her insurance, she then stopped taking her medications and checking her glucose, until she noticed bloody drainage on her clothes from rashes several places on her body.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #13: Epidemiology and Geography of Type 2 Diabetes Mellitus Part 2 of 5

Age- and sex-specific prevalence of diabetes: The prevalence of diabetes has been estimated by applying the WHO 1999 criteria for 13 European and 11 Asian cohorts participating in the DECODE and the DECODA studies. In Europe, the age-specific prevalence of diabetes rose with age up to 70s and 80s in both men and women.

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