Increase metformin or start insulin? - ghostwhowalks

[ArchivalUser]

25. A 50-year-old African-American woman returns to the office for follow-up of diabetes mellitus, which has been treated with diet; extended-release glipizide, 10 mg daily; and metformin, 500 mg twice a day. She says, "I do the best I can adhering to my diet." She tests her blood glucose concentration daily. For the past month her fasting blood glucose concentrations have averaged 170 mg/dL. Hemoglobin A1c 1 week ago was 8.4%. The patient is 167.5 cm (5 ft 6 in) tall and weighs 86 kg (190 lb). Which of the following is the most appropriate change in therapy?

A) Add chlorpropamide

B) Add insulin

C) Increase the metformin dosage

D) Stop the glipizide and metformin and start insulin

E) No change is indicated

[ArchivalUser]

Increase Metformin ,

Insulin is required only in longstanding diabetics(type ll)

[ArchivalUser]

CC: The maximum dosage of metformin is 2500 mg in three divided dosage

[ArchivalUser]

yes, thats the answer. Great! The trick is not to be swayed by by the 8.4 . Great going!

[ArchivalUser]

yes, increase the metformin. insuln is started only after maximum doses of the drug has been used.

[ArchivalUser]

C.. increase the dose to maximum if not controled then add another drug