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Production Assistant, Diabetes In Control

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #104: Treatment of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis Part 2

The effect of dietary intervention alone for the management of NAFLD and NASH has been evaluated extensively over the past 2–3 decades. These studies can be divided into two main types: those that have focused on weight reduction only, and clinical trials that have assessed the role of a particular dietary composition on hepatic steatosis.

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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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