Assignment task:
A 45-year-old male with type 2 diabetes comes to see his endocrinologist. His Hba1c had been 6.7 last visit 6 months back. His A1c now has gone up to 8.2 on recent labs. He is currently on metformin 1000mg bid. The patient had been following carb counting but has been non-compliant with his diet lately. He reports fasting glucose in the 150-230 range most days. He checks before dinner occasionally and reports glucose is usually over 200. He denies any hypoglycemia.
The patient has gained 15 lbs. weight in the past 6 months and has a BMI of 39. He does not have any long-term CV complications at this time. Family history is remarkable for both parents with type 2 diabetes and dad with coronary artery disease and unilateral above-knee amputation. The patient is tolerating metformin well. His BP is well controlled on lisinopril 10mg daily.
Answer Diabetes Case from the AACE case studies.
In your response, please provide the rationale for your answer utilizing the AACE guidelines