04-12-2007, 07:08 PM
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
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