Diabetic Case Study
An obese patient, age 45, comes to your office. She recently moved from another state three weeks ago and told you that her FNP diagnosed her with type 2 diabetes mellitus. She is currently not on any medicine for her diabetes, and she wishes to avoid insulin, if possible. She is a non-smoker. Her blood pressure is 138/74 mmHg. Labs from 3-weeks ago was hemoglobin A1C = 8.4%; total cholesterol = 260 mg/dL, triglycerides = 290 mg/dL, HDL = 49 mg/dL, LDL = 170 mg/dL (calculated 10-year ASCVD risk = 6.2%). You discuss current treatment goal recommendations endorsed by the ADA regarding glycemic control, blood pressure control, and lipid management. She agrees to start any medications that you recommend with lifestyle modification and a DASH diet to treat hypertension.
Q1. Which classes of diabetes medications are either weight neutral or cause weight loss? Please give one (1) example of a drug’s generic and trade name in that class.
Q2. Based on the current guidelines of the ADA, it would be appropriate to treat her with monotherapy since the patient is hesitant to take any injections. What agent would you recommend? Please provide the trade name, generic name, the dose you would start the patient with frequency, and route.
Q3. What are the contraindications of your selected diabetic therapy?
