Table 3: Blood pressure therapy, blood glucose levels and data from kidney function tests in a patient with hypertension and diabetes (Patient 5)


Date
2012

Blood Pressure
(Sitting and Standing)
Systolic/Diastolic (mmHg)

FBG
(mg/dL)

2-hPPG
(mg/dL)

HbA1c
(%)

Scr/eGFR
(mg/dL - ml/min)


F

2hPP


Feb 24

180/100
160/100

168

124

6.5

1.64
46

1.65
46


↑ metoprolol to 50 mg daily            Added chlorthalidone 25 mg daily


Apr 10

160/90
150/100

140

148

6.8

1.74
43

1.88
39


Therapy: chlorthalidone 25 mg daily     Patient did not take metoprolol


May 15

130/80
110/80

307

357

 

1.94
38

1.96
37


Therapy: Metoprolol 50 mg/d, chlorthalidone 25 mg/d, KCl 20 mEq/d
Action: Reduced chlorthalidone to 12.5 mg/d, increased KCl to 20 mEq BID


May 22

130-140/90
140/100

286

289

 

2.06
35

1.89
39


Therapy: As above     Prescribed Lantus insulin 25 units after breakfast and 25 units after dinner


June 22

120/82
110/80

88

133

 

1.62
47

1.67
45


Action: Continue current therapy         Return with Lab in in 6 weeks


Scr= Serum creatinine eGFR=estimated glomerular filtration rates

Mandal et al.Journal of Diabetes Research and Clinical Metabolism  2012 1:15DOI : 10.7243/2050-0866-1-15