Adult patient debuting with autoimmune-based type 1 diabetes (LADA)

Abstract

DESCRIPTION

A 60-year-old patient who went to the pharmacy feeling very tired and with significant weight loss. Lately, he has had a very dry mouth, and he goes to the bathroom a lot.

The patient uses levothyroxine 100 mcg as a chronic treatment to treat hypothyroidism. Interventions: after measuring blood glucose in the pharmaceutical office and obtaining 531 mg/dl as a result, we proceed to perform glycosylated hemoglobin, obtaining 10.9% as a result.

A written report is made where the results obtained in consultation are reflected and we refer it to the emergency room.

RESULTS

After visiting the specialist, the patient is diagnosed with autoimmune-based type 1 diabetes. The established treatment is as follows: toujeo 300 IU/ml (0/0/14 IU) and apidra (4/4/3). Since the patient presents many doubts about the diagnosis and its treatment, from the pharmaceutical office we proceed to carry out therapeutic education with her, about daily glucose controls, use of pens and the most appropriate diet for this health problem. The patient begins to present hypoglycemia (glycemia < 60 mg/dl), frequently at different times of the day. We proceed to carry out a gradual decrease (agreed with the patient) of the basal bolus insulin dose to reduce hypoglycemia situations until a visit to the specialist. After visiting the specialist again, he ratifies the gradual reduction pattern and establishes it at: Apidra (2/2/2) and Toujeo 300UI/ml (0/0/4UI).

DISCUSSION

The case reflects the important role played by the pharmacist as a health agent close to the patient in optimizing medication and detecting hidden health problems such as diabetes.