Dr. Shazli Naseer
DIABETES FELLOWSHIP - EASTERN CAROLINA UNIVERSITY ., AMERICAN BOARD OF FAMILY MEDICINE ., FAMILY MEDICINE
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Reviewing the laboratory results (attachment removed to protect patient identity), the patient has already developed significant damage, creatinine is too high and has already secondary hyperparathyroidism. Type 2 diabetes with renal complication. Dialysis is unavoidable, at this stage. To control diabetes and further renal damage, must avoid Metformin and must avoid a high dose of DD-4 or extended release Sulfonylurea. A safe option is low dose DD-4 or Insulin low dose weight adjusted. Keep diet in moderation for protein, does not need high protein diet and must follow up with nephrology.