Clinical Diabetes 22:43-45, 2004
© American Diabetes Association ®, Inc., 2004
Case Study: Uncontrolled Type 2 Diabetes in a 48-Year-Old Woman on Interferon ß-1b Treatment for Multiple Sclerosis
Hema Padmanabhan, MD
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Presentation
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M.W. is a 48-year-old woman with a 15-year history of type 2 diabetes that has been treated with insulin for 13 years. She has a history of multiple sclerosis for 8 years, and had been relatively stable for 7 years on interferon (IFN) ß-1b injections.
Recently she suffered from at least two exacerbations of the disease, requiring steroid therapy with intravenous methylprednisolone. She subsequently presented to the emergency room with uncontrolled diabetes (without acidosis). She also had a history of primary hypothyroidism (secondary to congenital absence of thyroid), hyperlipidemia, peripheral neuropathy, and nephropathy, but no evidence of hypertension or coronary artery disease.
From the time diabetes was diagnosed, her insulin regimen and dosage were modified several times. She received a thiazolidinedione (TZD) for a brief period, which was later discontinued because of bilateral lower extremity swelling. Her diabetes remained uncontrolled after the above hospitalization despite increases of her insulin dose to 52 units of glargine in the morning with 10–12 units of lispro with each meal. The fasting, premeal, and bedtime blood glucose levels remained at 270–330 mg/dl. Therefore, . . . [Full Text of this Article]
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Copyright © 2004 by the American Diabetes Association.
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