International Diabetes Center
Case Study #1
• 48 year old female with type 2 diabetes x 10 years
• Current therapy
– Metformin 1000 mg bid and Glargine 28 units at bedtime
• HbA1c 7.9%; Weight 65 kg.
Bed
1
2
4
3
142
(7.9)
139
(7.7)
111
(6.2)
124
(6.9)
129
(7.2)
28 G
5 (7.3) 132
196 (10.9)
184
(10.2)
202
(11.2)
136
(7.6)
(mmol/L)
Trang 2• Continue current therapy?
• Change/add oral agent?
• Adjust insulin?
• Add rapid acting insulin?
Trang 3International Diabetes Center
Orders
• Medication:
• Dose:
• Timing:
• Blood glucose testing:
• Target:
– Blood glucose
– HbA1c
Trang 4Case Study #2
• 64 year old female with type 2 diabetes for 6 years
• Current treatment is 70/30 insulin twice per day
• Height 1.7 meters, weight 69 kg
• Hypoglycemia 3x/week mid afternoon usually
• HbA1c 8.2%
Trang 5International Diabetes Center
Case Study #2
Logbook
Bed
1
2
4
3
185
(10.3)
166
(9.2)
179
(9.9)
144
(8.0)
189
(10.5)
30 U 70/30
18 U 70/30
5 (11.2) 201
134 (7.4 )
123
(6.8)
118
(6.6)
196
(10.9)
62 (12.1) 218
58 (10.7) 192
174 (9.7)
228 (12.7)
66
(mmol/L)
Trang 6• Continue current therapy?
• Add oral agent?
• Adjust insulin?
• Change to physiologic insulin regimen?
Trang 7International Diabetes Center
Orders
• Medication:
• Dose:
• Timing:
• Blood glucose testing:
• Target:
– Blood glucose
– HbA1c