45yrs male k/c/o type 2DM not on regular medications for the past 3months his FBS-260,PPBS-450
Uncontrolled negligent diabetic Rx priority for such pt is to control and convince and edjucate about disease Control bmi body weight and obesity Bring down hba1c 14.5% Plan of treatment Insulin basal bolus Regular insulin 20to30units tds bbf b/l and b/d with simultaneously monitoring of bsl and keep titration Or Inj actriped 25units bbf Inj mixtard 30:70 20units before lunch and dinner with monitoring bsl OHA I will suggest Tab metformin sr 500mg 1bd Tab dapagliflozin 10mg 1od Tab vildagliptin 50mg 1bd Or Tab metformin sr 500mg 1bd Tab glimiperide 2mg Tab pioglitazone 15mg 1bd or tab vildagliptin 50mg 1bd
Insulin is recommended... 1unit per kg in three divided doses regular insulin.Lantus inj 30 units t bed time. Then taper and add OHA T Metformin plus tab dapagliflizin and T Vidagliptin combination
His hba1c 14.5
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