CLINIC-Sim: Simulating a Patient-Centered Approach to Optimize Early Glycemic and Weight Control in Type 2 Diabetes

13 months since diagnosis (4-month follow-up)

• She returns 4 months later.
• She is taking a dose of 1500 mg metformin daily (500 mg in the morning and 1000 mg in the evening) without missing doses. She was not able to tolerate a dose of 1000 mg twice daily. Her HbA_1c has decreased to 7.7% from 7.9%, and her body weight remained stable.
• BMI: 33 kg/m² (195 lbs)
• Blood pressure: 130/85 mmHg
• Total cholesterol: 205 mg/dL
• LDL cholesterol: 110 mg/dL
• HDL cholesterol: 43 mg/dL
• Triglycerides: 260 mg/dL
• She increased her physical activity by parking farther and trying to walk more, but often struggles to find the time to get more exercise in.
• She tries to eat more balanced meals with protein, vegetables and fewer carbohydrates; she finds it difficult to make multiple meals for her family members who prefer to keep to their old dietary routine.
• She is motivated to continue working on lifestyle changes and has agreed to start a statin.