Diabetes Algorithim

Question 1

1st line Diabetes

Answer 1

Metformin
+ Oral
+Initially start at 500mg BID then increase by 500mg/week until desired BG level achieved

+Contraindicated eGFR <30

Question 2

Heart Failure & Diabetes

Answer 2

SGLT-2 Inhibitors
+ Oral
+ “ gliflozin “ drugs
Canagliflozin
Empagliflozin

Question 3

CKD & Diabetes

Answer 3

SGLT-2 Inhibitors until initiation of dialysis or transplant
+ Oral
+ Gliflozin drugs
+ If A1C above target on SGLT-2 consider adding GLP-1 RA “glutide” drugs
EX: Semaglutide

Question 4

ASVCD/ High risk factors

Answer 4

GLP - 1 RA
“ Glutide “ drugs
+SQ or Oral
EX: Semaglutide

These patients have established CVD
-OR-
High risk > or equal to 55 years with 2 or more risk factors such as obesity, HTN, smoking, dyslipidemia, and albuminuria