Interactive diabetes case 7: Management of diabetes in a 72-year-old patient with type 2 diabetes, GI bleeding, and multiple other medical problems – A4

ANSWER — Correct.

The normal glycated hemoglobin (A1C) is attributable to the intermittent blood transfusions the patient received. The A1C that is measured is predominantly that of the donors' blood. It does not reflect the patient's level of glycemia.

The patient is already on insulin without any evidence of hypoglycemia, so modest increases in the insulin doses to improve glycemia are reasonable and safe. However, there is no need to pursue tight glycemic management in view of his limited life expectancy.

Well done.

For additional information, see the comment at the end of this sequence. (See "Interactive diabetes case 7: Management of diabetes in a 72-year-old patient with type 2 diabetes, GI bleeding, and multiple other medical problems – Comment".)

To explore the consequences of the other actions, return to the case at the beginning of this sequence. (See "Interactive diabetes case 7: Management of diabetes in a 72-year-old patient with type 2 diabetes, GI bleeding, and multiple other medical problems".)