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15th July 2024
A 28-year-old man is seen in a diabetes clinic for his annual review. He was diagnosed with type I diabetes
A 28-year-old man is seen in a diabetes clinic for his annual review. He was diagnosed with type I diabetes at the age of 13 and is currently on a basal-bolus insulin regimen. Over the past year, he has been treated with antibiotics four times – twice for an infected ear piercing and twice for cystitis (symptoms of dysuria). The examination was normal except for two dot haemorrhages seen on fundoscopy. Blood pressure was 114/75 mmHg. Investigations were as follows:
| HbA1c | 75 mmol/mol (20 – 42) |
| fasting plasma glucose | 12.2 mmol/L |
| serum sodium | 136 mmol/L (137-144) |
| serum potassium | 3.7 mmol/L (3.7-4.4) |
| serum urea | 4.5 mmol/L (2.5-7.0) |
| serum creatinine | 85 µmol/L (60-110) |
| Urinalysis | glucose + |
| 24-hour urine protein | 0.7g (<0.2) |
Of the following options, which is the best to prevent progression of renal disease?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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