A 62-year-old man with type 2 diabetes mellitus of 10 years of evolution is treated with metformin and sitagliptin. He does little physical exercise and follows an adequate diet. In the last 6 months he has lost weight and has more asthenia. Her glycemic controls have deteriorated from baseline blood glucose levels of 110-140 mg/dL to 170-200 mg/dL, as well as her glycosylated hemoglobin which has gone from 7.1 to 8.5%. The most appropriate therapeutic measure to be taken is:
To associate a basal insulin dose to the treatment. Expected question on a very important subject: diabetes and its treatment. Patient poorly controlled with metformin and sitagliptin with discrete cardinal symptoms (weight loss, asthenia). The best option is insulin to control cardinal symptoms and decrease HbA1c to < 7%.
Increase dietary protein and long-chain carbohydrate intake to improve asthenia and weight loss.
To associate a basal insulin dose to the treatment.
Associate with ascarbose treatment.
Substitute sitagliptin for pioglitazone.
Substitute metformin for glimepiride.
Patient poorly controlled with metformin and sitagliptin with discrete cardinal symptoms (weight loss, asthenia). The best option is insulin to control cardinal symptoms and decrease HbA1c to < 7%.