Case Study with Voting: Intensification of Type 2 Diabetes Therapy in a Chronically Treated Patient. How to Proceed According to Current Recommendations?
We have prepared an interactive case study for you with a 70-year-old patient with decompensated Type 2 Diabetes. The patient was diagnosed with DM eight years ago. What treatment approach would you choose? And why? And how should you correctly proceed according to the current recommendations of SVL? Watch a short video with us.
MUDr. Ondřej Vrtal
Internal Medicine Department, České Budějovice Hospital, a.s.
In this case study, I describe the case of a 70-year-old patient with poorly controlled Type 2 diabetes.
Personal History
- Type 2 Diabetes Mellitus (duration 8 years)
- Very mild sensory neuropathy
- Hypertension
- Dyslipidemia
- Recurrent UTIs, vaginal mycosis during antibiotic therapy
Pharmacological History
- Glucophage XR 1000mg 0-0-1 tablet
- Tritace 5mg 1-0-0 tablet, Sortis 20 mg 1-0-0 tablet
- Frequent adverse reactions to various medications (dyspepsia, nausea, vomiting, diarrhea). Initially intolerant to metformin, tolerates only extended-release form at a maximum dose of 1000mg per day
Current Illness
- Poorly controlled Type 2 Diabetes Mellitus
- HbA1C 61 mmol/mol
- Fasting glucose 6 mmol/l
- Postprandial glucose 10-12 mmol/l
Work History
- Retired, formerly a primary school teacher
We recommend the article Treatment of Diabetics in the Practice of a General Practitioner: 7 Current Questions and Answers on this topic.
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