A 74-year-old woman with diabetes.
Ms M, a 74-year-old woman with type 2 diabetes of 6 years' duration, has a glycated hemoglobin (HbA1C) value of 7.4% despite taking 3 oral antidiabetic medications, as well as coexistent hypertension and abdominal obesity. She has no known microvascular or macrovascular complications of diabetes and is otherwise healthy. She is reluctant to commence insulin treatment as she dislikes the idea of injections and wonders if there are any alternate options if she is to get her HbA(1C) value below 7%. The natural history of type 2 diabetes, reasons why many patients begin requiring insulin over time, rationale for tight glycemic control, and therapeutic options for Ms M are discussed.
Abrahamson
Martin J
MJ
Harvard Medical School and Joslin Diabetes Center, Boston, Mass 02215, USA. martin.abrahamson@joslin.harvard.edu
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology* / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use
D007004:Hypoglycemic Agents; D007328:Insulin