Patient 5 ， Male, 68 years old, height 173cm, weight 83kg
About 7 years ago the patient became extremely thirsty and was found to be diabetic. He took Acarbose 150mg /per day and for first two years this controlled him blood glucose. Five years ago he added meltformin 750mg / day. One year ago, he added Glipizide7.5 mg / day as the third drug to improve his blood glucose control. For two months his fasting blood glucose levels were 8mmol/L, 13-17mmol/L after meals. After admission to BCDH, OGTT with insulin C-peptide levels were as follows: |
His other laboratory tests showed: HbA1c 9.5%, total serum cholesterol 5.5mmol/L and triglycerides 4.02mmol/L. His treatment was changed to diet, exercise and insulin injections. He started on Novolin 58u (R 44u, N14u) daily. In the first two days the blood glucose levels did not improve. His insulin dose was not increased but his diet improved with an increase in his exercise. After one month he lost 3kg and blood glucose levels improved. The insulin dose was reduced to 30u per day. OGTT with insulin and C-peptide levels was repeated as follows:
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