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Low Vision Assessment and Rehabilitation

Initial Management of Diabetes

Dr. Cole was enrolled in a diabetes education program of the Cosmopolitan International Diabetes Center, University of Missouri.

Dr. and Mrs. Cole received training in diabetic meal planning, and in the principles of gram scale weighing, food groups, and exchanges. A comprehensive meal plan was devised with a six-feeding 2,200 calorie/day base. This diabetes teaching protocol strengthened his knowledge of diabetes control to help prevent diabetic complications.

Insulin therapy was instituted, with a combination of regular and NPH insulin twice daily, increasing the insulin dosage incrementally as the oral hypoglycemic agents were withdrawn. He was stabilized with an insulin regimen of:

NPH insulin: 30 units AM and 20 units PM, plus
regular insulin 10 units AM and PM.

On this treatment, his hemoglobin A1c was controlled within the normal range and averaged 6% over a 2-year period. Moderate systemic hypertension was treated with Atenolol 50 mg po qd. Serum lipids including cholesterol were normal. A mild microalbuminuria, indicative of early diabetic kidney disease, was being followed.