Diabetes Series
Click on a question to view poll results
What is the glucose target for a patient with type 2 diabetes admitted to the ICU with pneumonia?
Results from 219 respondents:
<90 mg/dL
11.9%
<110 mg/dL
32.4%
110-140 mg/dL
47.5%
140-180 mg/dL
8.2%
<90 mg/dL
11.9%
<110 mg/dL
32.4%
110-140 mg/dL
47.5%
140-180 mg/dL
8.2%
A 48-year-old male patient with a 5-year history of type 2 DM currently on metformin (1000 mg bid) and pioglitazone (45 mg/day) presents complaining of some burning sensation in both feet. His A1C is 11.5.
What would be your next step with regard to his diabetes management?
What would be your next step with regard to his diabetes management?
Results from 113 respondents:
Add a sulfonylurea
4.4%
Add an incretin agent mimetic
2.7%
Add a secretagogue
2.7%
Add basal insulin
78.8%
Add basal insulin plus a secretagogue
11.5%
Add a sulfonylurea
4.4%
Add an incretin agent mimetic
2.7%
Add a secretagogue
2.7%
Add basal insulin
78.8%
Add basal insulin plus a secretagogue
11.5%
If you were to start a medication for the neuropathy, which one of the following would you select?
Results from 114 respondents:
Tricyclic antidepressant
13.2%
Gabapentin
67.5%
Pregabalin
11.4%
Duloxetine
7.9%
Tricyclic antidepressant
13.2%
Gabapentin
67.5%
Pregabalin
11.4%
Duloxetine
7.9%
An 18-year-old male presents with polyuria, polydipsia, weight loss and blood glucose readings of 280-400 mg/dL.
What initial treatment regimen do you prescribe?
What initial treatment regimen do you prescribe?
Results from 101 respondents:
Lifestyle modification
15.8%
Metformin
42.6%
Metformin plus glipizide
17.8%
Metformin plus glipizide plus glargine
23.8%
Lifestyle modification
15.8%
Metformin
42.6%
Metformin plus glipizide
17.8%
Metformin plus glipizide plus glargine
23.8%
Do you routinely advise your patients with type 2 diabetes to monitor their blood glucose?
Results from 116 respondents:
Yes, I advise my patients to test once daily.
43.1%
Yes, I advise my patients to test twice daily at set times.
17.2%
Yes, I advise my patients to test twice daily at varying times.
19.0%
Yes, I advise my patients to test multiple times daily.
6.0%
No, I do not routinely provide advice regarding blood glucose monitoring.
14.7%
Yes, I advise my patients to test once daily.
43.1%
Yes, I advise my patients to test twice daily at set times.
17.2%
Yes, I advise my patients to test twice daily at varying times.
19.0%
Yes, I advise my patients to test multiple times daily.
6.0%
No, I do not routinely provide advice regarding blood glucose monitoring.
14.7%
Case Profile: 55 y.o. man is diagnosed with diabetes; initial labs are glucose = 225 mg/dL and A1C = 8.6%.
How would you approach treatment in this patient?
How would you approach treatment in this patient?
Results from 80 respondents:
Lifestyle modification alone for 3–6 months
10.0%
Lifestyle modification and metformin
82.5%
Lifestyle modification and a sulfonylurea
2.5%
Lifestyle modification and insulin
5.0%
Lifestyle modification alone for 3–6 months
10.0%
Lifestyle modification and metformin
82.5%
Lifestyle modification and a sulfonylurea
2.5%
Lifestyle modification and insulin
5.0%
The patient is on glyburide and metformin and his A1c is 9.2%.
What treatment would you recommend next?
What treatment would you recommend next?
Results from 80 respondents:
Pioglitazone
28.8%
Sitagliptin
10.0%
Long-acting insulin 10 units q hs; follow-up visit for insulin adjustment in 1 month
12.5%
Long-acting insulin 10 units q hs to be increased by 2 units every 3 days as long as fasting glucose tests are above 130
48.8%
Pioglitazone
28.8%
Sitagliptin
10.0%
Long-acting insulin 10 units q hs; follow-up visit for insulin adjustment in 1 month
12.5%
Long-acting insulin 10 units q hs to be increased by 2 units every 3 days as long as fasting glucose tests are above 130
48.8%
Case Profile: 37 y.o. man with sedentary lifestyle presents for a routine annual physical exam:
- Past medical and family history: Negative
- Physical exam: No abnormality detected
- Height: 5 ft 8 in; Weight: 180 lbs
- BP: 128/76
- Lungs: Clear
- CV: Regular rate and rhythm
Results from 104 respondents:
Screen now with a fasting blood glucose
66.3%
Screen when he is 40 with a fasting blood glucose
10.6%
Screen when he is 45 with a fasting blood glucose
11.5%
Screen at any of the above ages using A1c
11.5%
Screen now with a fasting blood glucose
66.3%
Screen when he is 40 with a fasting blood glucose
10.6%
Screen when he is 45 with a fasting blood glucose
11.5%
Screen at any of the above ages using A1c
11.5%
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