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Production Assistant, Diabetes In Control

CGM Treatment Option

Do you recommend a CGM for all your patients who are not achieving their target blood glucose and who are on insulin? Follow the link to respond.

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CLINICAL CASE VIGNETTES: Diabetes Management Steps

Mr. Huang manages his diabetes with his lifestyle modifications, metformin, and linagliptin, and returns every 6 months for follow-up visits. Three years after initiating this treatment plan, he returns to your clinic for his 6-month check-up. When asked how his diabetes management is going at home, he shares that recently he has been “unable to really get out and get as much exercise as he knows he should due to his creaky, old knees acting up.” His current office A1C is 8.8%. You discuss with him what the next management steps may be to achieve his individualized glycemic goal. What would your next medical management step be? A. Add a rapid-acting insulin analogue B. Add a long-acting insulin analogue C. Add a GLP-1 agonist D. Add a sulfonylurea Follow the link for the answer.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #131: Pathogenesis of Type 2 Diabetes Mellitus Part 2

The natural history of T2DM has been well described in multiple populations and is reviewed in references [1] and [3]. Individuals destined to develop T2DM inherit a set of genes from their parents that make their tissues resistant to insulin and the insulin resistance is aggravated by weight gain and physical inactivity. Hepatic insulin resistance is manifested by an overproduction of glucose during the basal state despite the presence of fasting hyperinsulinemia [38] and an impaired suppression of hepatic glucose production (HGP)

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