Question

A 60-year-old Indigenous woman living in a rural community with limited access to fresh produce has long-standing type 2 diabetes complicated by neuropathy and nephropathy. Her HbA1c is 9.5% despite maximal metformin and basal insulin. She reports food insecurity and difficulty attending appointments due to lack of transport. What is the most appropriate next step?

Accepted Answer

Collaborate with community health workers to address food security and transport, while optimising her diabetes regimen

Answer

Increase insulin dose without addressing social factors

Answer

Refer her back to her primary care provider with no changes

Answer

Explain that complications are inevitable in diabetes and focus on palliation

Answer

Advise her to move to an urban area to get better care

Practice question