Abstract
Treating diabetes in obese patients is extremely challenging. Recently, physician’s use of U-500 regular insulin has increased to treat diabetes in this population. Here we report the use of the combination – insulin glargine, U-500 regular insulin and pramlintide to successfully manage type 2 diabetes in an extremely obese patient with a BMI of 54, A1C of 10.6 and a C-peptide level of 3.5 that indicated insulin resistance. With use of this combination of three drugs we were able to reduce the total number of drugs needed to manage patient’s diabetes from five to three, thereby also improving the likelihood of compliance.
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