27th May 2025

An 80-year-old female is attends the diabetes clinic for her annual review.

An 80-year-old female is attends the diabetes clinic for her annual review. She has a history of hypertension, chronic kidney disease, T1DM and gastroparesis. She currently takes metformin and 20 units of Humulin M3 in the morning and at dinner. You review her blood sugar diary and note that most mornings her blood glucose level is between 3 and 4, one morning her blood glucose was 15, she says she finds it difficult to get out of bed in the morning but feels better after she has breakfast. She has lost weight since her previous review and HbA1c has reduced from 55mmol/mol to 42mmol/mol. What is the best next step in management?

Select the SINGLE most appropriate option from the list below. Select ONE option only.