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A patient with T2D and other cardiorenal risk factors

Mr. S is a 57-year-old man with a history of hypertension, chronic kidney disease (CKD), and dyslipidemia. He was recently diagnosed with type 2 diabetes (T2D). He is a former smoker (10 pack-year history) who admits to occasional alcohol consumption. His family history is notable for cardiovascular disease (CVD), and his father passed away from a myocardial infarction at the age of 62 years.

Mr. S is taking the following medications:

  • Thiazide diuretic
  • Angiotensin II receptor blocker
  • Calcium channel blocker
  • Statin
  • Ezetimibe
  • Bempedoic acid

Recent physical exam and laboratory findings include:

  • Body mass index 26 kg/m2
  • Blood pressure 124/72 mm Hg
  • Total cholesterol 175 mg/dL
  • Low-density lipoprotein cholesterol 70 mg/dL
  • Urine albumin-creatinine ratio 36 mg/g
  • Estimated glomerular filtration rate 62 mL/min/1.73m2
  • Fasting plasma glucose 188 mg/dL
  • Hemoglobin A1C 7.3%

Mr. S has been counseled on lifestyle modifications. As you consider pharmacotherapy for T2D, you are also concerned about his CKD and high risk for CVD, knowing that the 3 conditions are interrelated and mutually amplify morbidity and mortality.

Based on T2D guidelines, which class(es) of glucose-lowering medication would you recommend to help Mr. S achieve his glycemic goals while reducing his cardiorenal risk, and why?

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Dysregulated microRNAs in type 2 diabetes and breast cancer: Potential associated molecular mechanisms

Source : https://pubmed.ncbi.nlm.nih.gov/38983808/

Type 2 diabetes (T2D) is a multifaceted and heterogeneous syndrome associated with complications such as hypertension, coronary artery disease, and notably, breast cancer (BC). The connection between T2D and BC...

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Youth-onset Type 2 Diabetes: An Overview of Pathophysiology, Prognosis, Prevention and Management

Youth-onset Type 2 Diabetes: An Overview of Pathophysiology, Prognosis, Prevention and Management

Source : https://pubmed.ncbi.nlm.nih.gov/38958831/

Youth-onset T2D is increasing in incidence and prevalence worldwide, disproportionately affecting First Nations communities, socioeconomically disadvantaged youth, and people of colour. Youth-onset T2D differs in pathogenesis to later-onset T2D and...

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Antidiabetic drugs in Parkinson's disease

Antidiabetic drugs in Parkinson's disease

Source : https://pubmed.ncbi.nlm.nih.gov/39149559/

This review explores the intricate connections between type 2 diabetes (T2D) and Parkinson's disease (PD), both prevalent chronic conditions that primarily affect the aging population. These diseases share common early...

This review highlights shared biochemical pathways between type 2 diabetes and Parkinson's disease, explores antidiabetic drugs as potential PD treatments, and discusses their experimental and clinical efficacy.