What to do with an A1C ? For the experienced clinician, this is a very simple question, but I occasional see orders for A1C’s at a rate more frequently than every three months. Remember that it is basically an average blood sugar over a period of approximately...
88 y/o with a history of depressive type symptoms was placed on an antidepressant to manage symptoms shortly after admission to a long term care facility. This particular patient was trialed on Zoloft (sertraline) and then transitioned to Cymbalta (duloxetine),...
A patient’s A1C was chronically high at around 9.0 with poor diet compliance. They were already reciving a fairly high dose of a sulfonylurea (glipizide) – remember that sulfonylureas stimulate the release of insulin. They were also on metformin 1000 mg...
I’m going to cover sulfonylureas tonight; this class is a mainstay in the treatment Type 2 diabetes. Other than metformin, these drugs are probably the most frequent oral class used. The most frequent names that come to mind are glipizide, glimepiride, and...
Today, it’s the DDP-4 inhibitors! DPP-4 inhibitors can be expensive which may limit their use from time to time. These drugs work to increase the amount of incretin in the body. You can look back at my post on Byetta/Victoza which should be under the diabetes...
I’m going to flip back to oral diabetes meds to cover a new agent that has recently been approved. It is a new class of diabetes med, but generally means it’s going to be quite expensive. This drug is Invokana (canagliflozin). It basically lowers glucose by causing an...
