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The patient is a 57-year-old male was seen in the office for a regular follow-up appointment for the management of secondary diabetes mellites and his insulin dosage. The AccuChek performed in the office a result of 400. The patient stated his glucose is usually over 300 when he checks it at home. He reported feeling fairly well, with a little more fatigue than usual. The patient is a retired truck driver and is fairly active, including helping his neighbors with yard work and snow shoveling. He has a history of pancreatic cysts treated surgically by partial pancreatectomy that has produced his secondary diabetes and postoperative hyperinsulinemia. Since it was noted that his blood glucose was at a critically high level, he was advised admission. He was admitted and seen by an endocrinologist, who carefully monitored his glucose levels and adjusted his insulin dosage until his glucose levels reminded at normal levels. No other complications of his diabetes were found. The patient was discharged with instructions to follow up with the endocrinologist in one week and to make an appointment for diabetic teaching in the diabetic clinic.
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