Part 3: Non-Insulin Treatments

Question 1

Person-centered approach

Answer 1

Look at glycemic goals
Look at weight goals
Risk of hypoglycemia
Hx of CVD and kidney disease
Medication cost

Question 2

Metformin: Brand names

Answer 2

Glucophage
Fortamet
Glumetza

Question 3

Metformin: MOA

Answer 3

Decreases hepatic production of glucose

Increases intestinal glucose utilization and decreases glucose uptake into circulation

Can increase GLP-1 secretion

Modest effect on increasing tissue uptake and utilization of glucose by muscle

Question 4

Metformin: Clinical applications

Answer 4

As adjunct in type 2 that are uncontrolled

In combo with insulin and other non-insulin agents in T2DM

Question 5

Metformin ADA recommendations

Answer 5

Consider for use in all type 2 patients, if tolerated and not contraindicated

-Shown to reduce the risk of mortality and CV death
-Extensive experience
-Efficacious with minimal hypoglycemia
-Positive and/or weight neutral effects on weight
-Widely available and inexpensive