SFE2005 Poster Presentations (1) Diabetes, metabolism and cardiovascular (12 abstracts)
Hemel Hempstead Hospital, Hemel Hempstead, HERTS, United Kingdom.
58 year old man – Mr CB
Type 2 diabetes for 16 years
Well controlled hypertension
Microalbuminuria with ACR 19
Persistent haematuria with stone disease
No retinopathy or neuropathy
No macrovascular disease
Otherwise fit and well
Obese with BMI 33, not responsive to dietary modification
Dyslipidaemic with Cholesterol 6.4, Trigs 5.9
On Metformin 1 g tds, Lisinopril 2.5 mg od, Bezafibrate MR 400 mg od, Aspirin 75 mg od
Persistently high HbA1cs of around 10%
Initiated on Rosiglitazone 4 mg od
Weight unchanged
Continued sub optimal control after 6 months but slight improvement in HbA1c to 9.3%
Would you initiate insulin treatment at this stage; increase Rosiglitazone to 8 mg od or add a sulphonylurea?
Trial of Gliclazide 80 mg od
Also changed fibrate to Simvastatin 40 mg on
HbA1c improved to 7.3%
Persistently reasonable
Last HbA1c 6.5%
Cholesterol 4.2, HDL 0.9, Trigs 2.1
A vindication for the unlicensed triple oral therapy approach?
58 year old man – Mr CB
Type 2 diabetes for 16 years
Well controlled hypertension
Microalbuminuria with ACR 19
Persistent haematuria with stone disease
No retinopathy or neuropathy
No macrovascular disease
Otherwise fit and well
Obese with BMI 33, not responsive to dietary modification
Dyslipidaemic with Cholesterol 6.4, Trigs 5.9
On Metformin 1 g tds, Lisinopril 2.5 mg od, Bezafibrate MR 400 mg od, Aspirin 75 mg od
Persistently high HbA1cs of around 10%
Initiated on Rosiglitazone 4 mg od
Weight unchanged
Continued sub optimal control after 6 months but slight improvement in HbA1c to 9.3%
Would you initiate insulin treatment at this stage; increase Rosiglitazone to 8 mg od or add a sulphonylurea?
Trial of Gliclazide 80 mg od
Also changed fibrate to Simvastatin 40 mg on
HbA1c improved to 7.3%
Persistently reasonable
Last HbA1c 6.5%
Cholesterol 4.2, HDL 0.9, Trigs 2.1
A vindication for the unlicensed triple oral therapy approach?