Diabetes Mellitus
1. WL is a 56-year-old man with type 2 diabetes. He has been coming to your diabetes clinic for 15 years. His creatinine clearance = 48 mL/min, body mass index = 31 kg/m2, and A1C = 8.1%. He has a sulfonamide allergy. He is very adherent with his medications, which include metformin 850 mg po tid and pioglitazone 30 mg po qd. He refuses to initiate basal insulin injections, as per your recommendation.
2. FG is a 64-year-old African American woman with a medical history significant for hypertension, coronary artery disease, chronic obstructive pulmonary disease, type 2 diabetes mellitus, and diabetes-induced gastroparesis. She presents to your diabetes clinic with her chief complaint that “my sugar is always high.” Her readings are as follows: finger-stick (fasting) blood glucose = 290 mg/dL, creatinine clearance = 50 mL/min, and A1C = 12.4%. Her current diabetes medications are as follows: metformin 1 g po bid, glyburide 10 mg po qd, and pioglitazone 45 mg po qd.
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