Tag Archives: What anti-diabetic medications have compelling evidence for use in select populations possibly as initial therapy?

Module II: Diabetes/Endocrine Topic Discussion

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Often we see a great deal of misinformation in the care of patients with diabetes, and often this misinformation is centered around the role and choice of medications.

Many patients, especially newly diagnosed patients, are prescribed medications that do not fit into the scheme of the ADA / AACE guidelines / best evidence based practices – for instance, starting on Januvia (sitagliptin) or Rybelsus (semaglutide)  as initial monotherapy without a compelling indication or reason.

In this discussion please talk about how patients get put on these medications and why/how they should be transitioned to more evidence based treatments.,

• • Is it okay to start a patient on a drug (particularly an oral drug) other than metformin as an initial drug?,  Please cite possible circumstances where this could be reasonable.,
  • What anti-diabetic medications have compelling evidence for use in select populations possibly as initial therapy?,
    • (eg. SGLT2Is – Patients with type 2 diabetes and a high risk of cardiovascular disease had reduced risk of a cardiovascular death nonfatal myocardial infarction or nonfatal stroke relative to those randomized to receive placebo),
  • What additional medications other than those for glucose control  should be included in a comprehensive pharmacotherapeutic plan and why?, [See textbook section on Treatment of Concomitant Conditions]

Now let’s consider the following case about thyroid disorders. A 69-year-old man goes to his family doctor because he has been feeling fatigued and lethargic. His doctor does a complete evaluation., This patient had a myocardial infarction and has a recurrent ventricular arrhythmia (treated with amiodarone). The patient’s TSH is elevated and his T₄ is slightly decreased.

• Please provide an evaluation of this patient’s condition, approach to therapy and factors you have taken into consideration

Submit  your completed responses, [MS Word document or equivalent] to the Assignment folder “Discussion Post Originality Check”  for Turnitin similarity checking. Click on the ‘Assignments’ link in the course navigation bar to locate the assignment folder. You are required to achieve an acceptable similarity score before posting to the discussion board.  See the Course Resources module’s subfolder ‘Turnitin’ for policy and algorithm (acceptable score) details. 

Discussion posts placed on D2L prior to Monday morning at 12:01 AM ET are not graded. Post your initial response by Thursday at midnight. Respond to at least one student by Saturday at midnight. Students are encouraged to respond to more than just the 1 required post to promote an engaging classroom experience. Both responses should be a minimum of 250 words, scholarly written, APA formatted, and referenced.  A minimum of 2 references are required (one may be the textbook). Refer to the Grading Rubric for Online Discussion in the Course Resource section.