Uncontrolled diabetes

Female pt of age 33 Married Chief Complaints Large boil over back Taking medication for this but not relief History No history of taking medication for dm Vitals Bp:130/84 Pulse:88 Sp02:98 Temp:98.2 Weight 62 kg Rbs:390!! 26/01 Physical Examination Complain of weight gain in last few months Investigations I advice on 26/01 Cbc Lft Kft Bsf and pp Hb1ac Lipid profile On 27/01 Cbc normal Lipid/kft/lff normal Hb1ac:10.2 Bsf:280 Pp:390 Diagnosis DM2?? Management Tab:cefuroxime 500 bd Enzoflam one bd Glycomet gp3 one bd After three days of tt Large pus discharge from boil Pain relief But RBS done Day one of TT 340 28/01 Day two 309 29/01 Day 3 357 30/01 What will be next step should taken!?

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Need to go for I and D of boil. Start insulin Basal insulin with SU+ Met + DPP4 in initial dose... go for repeat checkup of FBS, PPBS daily... OHA are slower in initial response in background infective stress...

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Noncompliant uncontrolled diabetic Burst abscess As pt was not taking medication for diabetes and infected abscess was present hence without insulin it is difficult to control bsl Better shift on regular insulin with OHA in low doses Debride the abscess and dress with betadine packing Keep on broadspectrum antibiotics Antiinflamatory Monitor bsl frequently and titrate insulin and OHA

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Do C peptide level to dia type 1 or type2 Start s/c Novomix30 flexipen 12unit bbf 8 unit bd Dose of insulin should be titrated according to bs F ,PP,BD level

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