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Dec. 16, 2017

My good friend David Kliff always seems to hit the nail on the head when it comes to evaluating diabetes companies and the battles for insurance coverage and pricing. He often discusses the idea that insulin is a commodity, and formulary choices are not based on advertised prices, but on …

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Initiating Therapy

One of your patients has referred her 21-year-old stepson for a new patient exam. He has recently arrived home from college for the summer and she is concerned because he always seems to be thirsty. When prompted, she recalls her husband saying his ex-wife struggled with her weight and took “pills for her blood sugar.” Physical examination is notable for mildly elevated BP (137/84) and BMI 26 kg/m2. He denies any cigarette or alcohol use, states his favorite activities revolve around video games, and that he doesn’t really enjoy any physical activities. Labs are notable for random plasma glucose 312 mg/dl, UA positive for glucose. What would your initial drug therapy strategy be? A. Initiate monotherapy with metformin B. Initiate a combination therapy with two noninsulin agents C. Initiate lifestyle modifications D. Initiate insulin therapy Follow the link for the answer.

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