Doubling of Hemoglobin A1c on PCSK9 Inhibitor Therapy

A 70-year-old man with history of cerebrovascular accident, hyperlipidemia, and type 2 diabetes mellitus presented with polyuria, polydipsia, and weight loss. Severe hyperglycemia (serum glucose, 585 mg/dL) was present on admission. No precipitating factors were identified. Initial laboratory findings were also notable for elevated aspartate aminotransferase (703 IU/L) and alanine aminotransferase (779 IU/L). Diabetes mellitus, diagnosed 4 years prior to presentation, was managed with glipizide.

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