NUR 631 Topic 13 Discussion Question 2

NUR 631 (Advanced Physiology & Pathophysiology) Topic 13 Discussion Question 2 Ms. C is a 28-year-old Casino Floor Manager. She had gestational diabetes during her fourth pregnancy which she delivered about a year ago and during that time she was treated with NPH BID and NovoLog QID with meals. After delivery she started Metformin and then after that Pioglitazone and Sitagliptin and Glimepiride were added. She eats three meals a day. She prepares them at home. She doesn’t eat fast food or junk food and she’s pretty consistent with what she eats day-to-day. She’s very active, exercises regularly and when she sees you in the office her A1C is despite all that she is doing to control the sugars, her A1C is 8.9. What are your treatment options? Give probable diagnosis and differentials