45yo obese man uncontrolled T2DM for 3 years that implicated with early retinopathy. No cardiac risk factor, on metformin 10000gm TID, sitagliptin 100mg OD. His HA1C is 8% with normal renal function, he has significant fear for hypoglycemia. Best additional therapy?
سؤال مجاني 4 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Empgafliglazone
He is obese, fears hypoglycemia and needs a third agent. An SGLT2 inhibitor (empagliflozin) lowers glucose without causing hypoglycemia and promotes weight loss. Gliclazide and repaglinide (secretagogues) and prandial insulin all carry hypoglycemia risk and weight gain, so they suit him poorly.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Gliclazide is a sulfonylurea; under the goal of less hypoglycaemia the slides say to avoid sulfonylureas.
✓ 11• Diabetes Mellitus [Slides].pdf · p. 7 -
B
ليش صح
For a patient who wants less hypoglycaemia and weight loss, the slides list SGLT2 inhibitors (empagliflozin) under both goals.
✓ 11• Diabetes Mellitus [Slides].pdf · p. 7 -
C
ليش غلط
Repaglinide's listed side effects are hypoglycaemia and weight gain, the two things this patient wants to avoid.
✓ Anti-diabetic.pdf · p. 4 -
D
ليش غلط
With bolus (pre-meal) insulin, the risk of hypoglycaemia is a serious concern, and he fears it.
✓ Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 8 -
E
ليش غلط
For his goals the slides list GLP-1 agonists, DPP-4 inhibitors and SGLT2 inhibitors (weight loss) plus thiazolidinediones (less hypoglycaemia); alpha-glucosidase inhibitors are on neither list.
✓ 11• Diabetes Mellitus [Slides].pdf · p. 7
- المصدر
- 11• Diabetes Mellitus [Slides].pdf · p. 7
Endocrine ✳️.pdf · p. 9 - المحاضرة
- Diabetes Mellitus · Endocrinology · Module B
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- Endo bank