PATIENT PRESENTATION
58-year-old female, T2DM for 12 years. Currently on Metformin 1g BD + Glipizide 5mg OD. HbA1c: 8.9%. BMI: 28.4. No CKD. Complains of 2-3 hypoglycaemic episodes/month. Employed as school teacher, long irregular hours.
KEY CLINICAL CHALLENGE
Persistent hyperglycaemia despite dual OHA with recurrent hypoglycaemia on SU. Patient reluctant for injectable therapy. Cardiovascular risk: moderate (borderline hypertension, family history of MI).
PATIENT PRESENTATION
63-year-old male, post-PTCA (2021), T2DM for 8 years. On Metformin 500mg BD, Atorvastatin 40mg, Aspirin 75mg. HbA1c: 9.2%. eGFR: 58 mL/min. Mild microalbuminuria.
KEY CLINICAL CHALLENGE
High cardiovascular risk requiring glucose-lowering with proven CV benefit. Mild CKD restricts some agents. Patient needs holistic cardiometabolic management with renal protection.
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