After taking glipizide (Glucotrol) for 9 months, a client experiences secondary failure. Which of the following would the nurse expect the physician to do（）
A. Initiate insulin therapy.
B. Switch the client to a different oral antidiabetic agent.
C. Prescribe an additional oral antidiabetic agent.
D. Restrict carbohydrate intake to less than 30% of the total caloric intake.
参考答案：B
解析：
Many clients (25% to 60%) with secondary failure respond to a different oral antidiabetic agent. Therefore, it wouldn’t be appropriate to initiate insulin therapy at this time. However, if a new oral antidiabetic agent is unsuccessful in keeping glucose leveis at an acceptable level, insulin may be used in addition to the antidiabetic agent. A client who has diabetes should get about 70% of his calories from carbohydrates and monounsaturated fats.