47 year-old African-American woman with three children and one unsuccessful pregnancy. She has a full-time clerical job for a transportation company. On her last pregnancy five years ago, she had gestational diabetes. No other significant history.
She returns for her annual check-up. Her lab tests were drawn pre-visit.
Compliance with meal plan?
| Compliance with exercise plan? |
Does not exercise regularly.
African-American women are at higher risk for type 2 diabetes. Together with her gestational diabetes and obesity, type 2 diabetes is a strong likelihood.
The American Diabetes Association recommends repeating the fasting blood glucose to confirm the diagnosis of diabetes. Some physicians faced with a patient who has an elevated A1c and high blood glucose may choose to initiate therapy without repeating the lab tests.
|How would you initially treat this patient?|
|Diet and exercise alone|
|Diet and exercise plus an oral agent|
|Diet and exercise plus an incretin mimetic|
Diet and exercise plus insulin
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