Interactive diabetes case 6: Uncontrolled diabetes in a 64-year-old patient treated with insulin – A1

ANSWER — Incorrect.

The patient's body mass index (BMI) is 21 kg/m². She does not need a reduction in caloric intake. In fact, she needs an adequate caloric intake to maintain normal nutrition and her current body weight. Also, a reduced caloric intake may increase the frequency of insulin reactions.

Approximately 10 percent of adult patients who are initially classified as having type 2 diabetes have type 1 diabetes (latent autoimmune diabetes of the adult) (see "Interactive diabetes case 4: Uncontrolled diabetes in a 51-year-old patient on insulin and two oral agents"). This patient has type 1 diabetes based on the history of diabetic ketoacidosis, the apparent lack of insulin resistance, the absence of other features of the metabolic syndrome (such as obesity, hypertension, and hypercholesterolemia), and the lability of the blood glucose values. When tested, the patient is found to have anti-islet antibodies. She needs a physiologic regimen of insulin replacement.

Return to the beginning to try again. (See "Interactive diabetes case 6: Uncontrolled diabetes in a 64-year-old patient treated with insulin".)