A 48-year-old Caucasian man presents to his primary care pharmacist for a follow-up visit for type 2 diabetes management. He weighs 165 lb, with a BMI of 27.5 kg/m2, and his medical history is significant for type 2 diabetes, proliferative diabetic retinopathy, diabetic peripheral neuropathy, albuminuria, hypertension, hyperlipidemia, and obstructive sleep apnea. His medications include metformin extended release 2,000 mg daily, 500 units/mL (U-500) regular insulin 80 units subcutaneously in the morning and 80 units subcutaneously in the evening, 300 units/mL (U-300) insulin glargine 60 units subcutaneously once daily, tirzepatide 7.5 mg subcutaneously weekly, lisinopril 20 mg daily, finerenone 20 mg daily, and rosuvastatin 40 mg daily. He has ready-to-use glucagon for emergencies and uses a continuous glucose monitoring (CGM) system. He had been referred to an endocrinologist and had several appointments over a 1-year period, but then stopped going because he felt that there was nothing added,...

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