Home > Focus Areas > Type 2 Diabetes Connect > Post
  • Saved

1yr
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?

  • 1yr
    start him on SGLT2 AND OZEMPIC DIABETES CONTROL,RENAL PROECTION WITH DECREASE PROTEINURIA ALSO CARDIOVASCULAR PROTECTION
  • 1yr
    start him on sglt2 for diabetes and kidney for diabetes and cardiovacular protection
  • 1yr
    start on SGLT2 and ozempic had protection for both cardio and renal and lowering a1c
  • 1yr
    start on SGLT2 and ozempic had protection for both cardio and renal and lowering a1c
  • 1yr
    start on SGLT2 and ozempic had protection for both cardio and renal and lowering a1c
  • 1yr
    start on SGLT2 and ozempic had protection for both cardio and renal and lowering a1c
  • 1yr
    Sgl2 or ozempic. Wax Pink elephant, Metformin, ever taken?
  • 1yr
    Mr S would definitely benefit from A SGLT 2 inhibitor , either Jardiance or Farxiga would be a good choice. Ozempic also deserves consideration as it has shown both cardiac and renal benefits in clinical trials. I would , therefore, start him on Jardiance or Faxiga, and add Ozempic for additional lowering of A1c and other cardio metabolic benefits if need be
  • 1yr
    GLP-1 ra, GLP-1 ra/GIP, MRA, SGLT2. Would start GLP-1 or GLP-1/GIP first to see if hyperresponder.
  • 1yr
    SGLT-2 inhibitor preferably dapa or empa
  • 1yr
    given his BMI of 26 and elevated UAC ratio, I would also recommend SGLT-2 therapy to reduce the risk of CVD complications as recommend by ADA
  • 1yr
    SGLT2 is a must for all mentioned issues for renal, cardiovascular and Dm... also helps with HTN.
  • 1yr
    SGT2 inhibitor for sure !!!! Wonder why it was not in first place with a Hba1c of 7.3 when he was first diagnosed with diabetes ! It is the writing on the wall now that this class should be started as soon as possible ! with the massive evidence to endorse the use of these agent in a vignette like this ! and my choice would be to use Jardiance given the ovewhelming data to suggest improved CV outcomes and prevent the progression of CKD as shown in this pt with the microalbuminuria !!
  • 1yr
    Yes agree that SGLT2 inhibitor is the way to go on this patient.
  • 1yr
    To reduce cv risks and help control T2D , reduce ckd risk progression, will start sglt-2 inhibitor like jardiance or farxiga
  • 1yr
    SGLT2 inhibitors
    Such as Dapa or Empa

Show More Comments