A 55-year-old white male sees you for a routine an - elbamaritza

[ArchivalUser]

A 55-year-old white male sees you for a routine annual visit. His fasting blood glucose level
is 187 mg/dL. Repeat testing 1 week later reveals a fasting glucose level of 155 mg/dL and an
1c HbA of 9.4%. His BMI is 30 kg/m . He does not seem to have any symptoms of diabetes 2
mellitus.
In addition to lifestyle changes, which one of the following would you prescribe initially?
A) Metformin (Glucophage)
B) Glyburide (DiaBeta, Micronase)
C) Rosiglitazone (Avandia)
D) Bedtime long-acting insulin (Lantus)
E) Bedtime long-acting insulin and rapid-acting insulin (Novolog) with each meal

[ArchivalUser]

metformin

[ArchivalUser]

yup metformin can give for even obese pts..

[ArchivalUser]

ANSWER: A
Metformin is widely accepted as the first-line drug for type 2 diabetes mellitus. It is relatively effective, safe,
and inexpensive, and has been used widely for many years. Unlike other oral hypoglycemics and insulin,
it does not cause weight gain. It should be started at the same time as lifestyle modifications, rather than
waiting to see if a diet and exercise regimen alone will work.
If metformin is not effective, a sulfonylurea, a thiazolidinedione, or insulin can be added, with the choice
based on the severity of the hyperglycemia.
Ref: Heine RJ, Diamant M, Mbanya JC, et al: Management of hyperglycemia in type 2 diabetes: The end of recurrent failure? BMJ
2006;333(7580):1200-1204.