Endocrinology eConsult
Diabetes with CKD
SPECIALTY
Endocrinology
CHIEF COMPLAINT
Diabetes with CKD
COMMENTS TO SPECIALIST
This is a 61-year-old male who has uncontrolled Type 2 Diabetes Mellitus (T2DM). His most recent A1C was 10.8. He was on Trulicity® 1.5 and Lantus® 47 units bid. He has Stage 4 Chronic Kidney Disease (CKD 4) with a baseline creatinine of 2.5. Fasting Blood Sugar (FBS) was generally <150, but PP was 200-300.
I increased his Trulicty ® to 3mg, changed his Lantus to 40 units q 12 hours, and started logging FBS tid with meals. He then was getting some FBS < 70, so I decreased his Lantus to 35 units q 12 hours. I will review his blood sugar this week.
MAIN QUESTION
Do you have any other suggestions?
TrueCare: Care Efficiency for Underserved Patient Populations
Like many non-profit Federally Qualified Health Centers (FQHC) that work with underserved patient populations, TrueCare faces significant challenges in obtaining specialty care for its patients. Reasons that vulnerable patients – a group that includes the elderly, rural residents and immigrants- experience difficulty accessing specialty care include a scarcity of specialists who accept Medicaid due to low reimbursement and patients’ own difficulty in arranging childcare and/or transportation. This leads to long wait times for appointments, reduced access to care and deteriorating health for Medicaid patients unable to obtain needed specialty care.
Read more about how TrueCare solved significant issues in access to specialty care for their safety net patient population through the AristaMD platform.