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For each of the following Diabetes Patient Scenarios – please identify your treatment plan including rationales. Also, if prescribing any medications, include complete written prescriptions. Identify follow-up recommendations as well. Also, identify the standardized guidelines that you should use to assess and treat these patient? Case 1 Sarah is in the clinic for a follow-up visit. She is a 62 year old white female with type 2 diabetes mellitus who has been unable to reach target glycemic control with Metformin 2500 mg/day and taking a GLP1 RA medication. She has a BMI of 24 and has been walking 3 miles a day 5 days a week since being diagnosed with diabetes 3 years ago. Her current HBA1c is 8.2 and was 8.4 at her last visit 3 months ago. What would your treatment plan be for Sarah? – Be specific with medications & dosages. Case 2 John is a 55-year male presenting today to review his blood work. All labs (CBC, CMP, Lipids, PSA) done last week are within normal limits except for a FBS of 222 mg/dl. A point-of-care HBA1c was completed in the office today with a result of 7.8. Vitals today in the office are: Ht: 5’8”, Wt: 210 lbs, T:98.2, P: 68, R: 12, BP: 118/68, O2 Sat: 97%. Physical Exam is unremarkable NKA No significant medical history What would your treatment plan be for John? – Be specific with medications & dosages. Case 3 Bill presents in the office today for a diabetes follow-up. He is 68 years old and has been managing his diabetes with metformin 2500 mg/day for the last 2 years. Over the last two weeks, he is finding his BG readings have been over 200 for both morning and throughout the day. He has not changed is diet or activity- he continues to walk 4 days a week for one hour a day. He continues to take Amlodipine 10 mg daily for hypertension. His most recent labs (CBC, CMP, Lipids) of 2 weeks ago were within normal limits other than his FBS reading of 180 mg/dl. Ht: 6’0” Wt: 195 lbs, T:97.2, P: 70, R: 12, BP: 120/82, O2 Sat: 97%. Physical Exam is unremarkable What would your treatment plan be for Bill? – Be specific with medications & dosages.

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