AKT-4700

AKT-4700

You are a healthcare professional working in a general practice. Your next patient is a 70-year-old man who has come for a follow-up appointment to review his recent blood test results. During his last visit, you had expressed concern about his elevated plasma glucose levels and advised him to make some lifestyle changes. He informs you that he has made some dietary modifications and has started walking to the nearby stores instead of driving.

The patient has a medical history of coeliac disease, osteoarthritis, and chronic kidney disease. His fasting blood test results are as follows:

– Hemoglobin (Hb): 146 g/L (normal range for males: 135-180; females: 115-160)
– Platelets: 235 * 109/L (normal range: 150-400)
– White blood cells (WBC): 7.0 * 109/L (normal range: 4.0-11.0)
– Sodium (Na+): 139 mmol/L (normal range: 135-145)
– Potassium (K+): 4.4 mmol/L (normal range: 3.5-5.0)
– Urea: 10.4 mmol/L (normal range: 2.0-7.0)
– Creatinine: 216 µmol/L (normal range: 55-120)
– Estimated glomerular filtration rate (eGFR): 28 ml/minute
– C-reactive protein (CRP): <5 mg/L (normal range: <5)
– Plasma glucose: 7.3 mmol/L (normal range: <6 mmol/L)
– Hemoglobin A1c (HbA1c): 54 mmol/mol

What would be the most appropriate course of action for managing this patient’s HbA1c levels?