In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.
Did you know that your browser is out of date? To get the best experience using our website we recommend that you upgrade to a newer version. Learn more.

Person not achieving tight targets despite triple therapy

Kamlesh Khunti, Leicester General Hospital, UK

The case

Max Oakley, is a 68 years old retired teacher, lives with his wife who is working full time. Mr Oakley has been depressed since retiring and his diet is poor.

He is overweight (BMI 29), he has had type 2 diabetes for 11 years. Currently, he is going to see GP since he is having visual disturbances.

His diabetes medications are Metformin 1g bd, Dapagliflozin 10mg od, and

Trulicity (dulaglutide) once weekly (started 3 months ago).

The HbA1c is 69 mmol/mol (8.5%) and it has increased since last time measured, six months ago, then the HbA1c was 60mmol/mol (7.6%).

Test your knowledge:



Note: The views and opinions expressed on this page are those of the author and may not be accepted by others. While every attempt is made to keep the information up to date, there is always going to be a lag in updating information. The reader is encouraged to read this in conjunction with appropriate ESC Guidelines. The material on this page is for educational purposes and is not for use as a definitive management strategy in the care of patients. Quiz material in the site are only examples and do not guarantee outcomes from formal examinations.