Advancing oral treatment for Type 2 diabetes
Your obese type 2 diabetes patient, who is 58 years old, has been on metformin, but recent HbA1C levels are around 8.2%, despite attempts at controlling diet and exercise. The patient realizes something must be done and would very much like to maximize A1C reductions with the next option, hoping to achieve levels closer to a goal of 7.0%, if not below that, to avoid having to add multiple further medications. However, the patient hopes to avoid injectable medications if they are not completely necessary. The patient would also like to lose weight.
What medication would you recommend next?
Would your recommendation differ if the patient had a history of atherosclerotic cardiovascular disease?
How would you help this patient stay compliant with your prescribed treatment regimen?
Show More Comments
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William Ameen 2 weeks 1 day
Obviously, one must confirm that the patient is actually taking metformin, and if he can be believed, make sure he's on the maximum tolerable dose, 1000 mg of the extended-release Show More -
Sai Kolla 2 weeks 3 days
Check his diet in detail, cut down Carbs 50% what he is taking and follow HbA1c. If not controlled, add januvia 50mg once daily
