write a referral letter to an endocrinologist

I am writing to refer Ms Tabtha Taborlin, a 45- year-old patient, who is a poor

control

type one diabetes with intermittent diabetic ketoacidosis (DKA). She requires your assessment and management for the rigid glycemic

control

and

insulin

pump insertion as you deem appropriate. Ms Taborlin has been struggling with diabetes since she was 7 years old. she is a noncompliant patient with recurrent ketoacidosis and admission. 4 days back she was admitted with dehydration and a glucose level of 530 mmol/l on admission. She was taking

insulin

with the dose of 45 units of Lantus and 12 units of Humalog nightly and an additional pre-prandial correctional scale with the Humalog,

however

, she had not used it regularly. She does not exercise and she smokes 2 cigarettes per day. She is underweight and she has essential hypertension as well. Despite discussing the necessity of strict glucose

control

and regular

insulin

injections, she still doesn’t use

insulin

regularly and does not follow the recommended diet. It would be great if you could visit her and give us your valuable opinion about an alternative treatment plan for better glycemic

control

such

as

insulin

pump. Yours sincerely, Doctor