AR is a 53-year-old Jordanian Arab woman living in Amman who has a 4-year history of Type 2 diabetes, currently managed with metformin 1000 mg twice daily, increased exercise, and nutritional modification (including less use of fats, oils, and sweeteners in cooking). AR presents to her primary care physician to discuss her desire to undergo a prolonged fast during Ramadan. Comorbid conditions include hypertension and asthma. She is a full-time housewife and mother of five. She is 1.60 m (5 feet 3 inches) tall and weighs 71.2 kg (157 lb).
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AR has been taking metformin 1000 mg twice daily for approximately 3 years. Other medications include simvastatin 20 mg once daily for the past year, enalapril 20 mg once daily for the past 3 years, and an inhaled combination product (β-agonist plus corticosteroid) to control asthma symptoms. She experienced weight loss when the anti-diabetes treatment was initiated (at which time she also began the exercise regimen and the nutritional modification), but this weight loss was not sustained for long. Her current weight of 71.2 kg (157 lb) has been unchanged for the past 2 years.
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--Interactive
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