This is an interesting patient who I recently had.
Patient is a 36 year old male who developed pancreatitis in 2008 and experienced multiple flare ups over the course of 5 years. After many studies and follow-ups with specialists there was no underlying cause determined. In 2013 the patient had pancreatitis which resulted in pancreatic failure with necrotizing tissue present. Patient underwent a total pancreatectomy with islet cell transplant in 2013. Post surgery the patient required insulin short term but has not had any intervention over the last 10 years.
Labs obtained:
c-peptide: 0.94 ng/mL
HbA1c: 6.2%
Fasting glucose: 126 mg/dL
Dexcom Report:
Average Glucose: 144 mg/dL
Standard deviation: 27
Very High: 0%
High: 11%
In Range: 89%
Low: 0%
Very low: 0%
How would you treat this patient?
--
Amy Rich, DNP, CRNP, CDE
Doctor of Family Nurse Practitioner
Certified Diabetes Educator