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Production Assistant, Diabetes In Control

Weight Loss Assistance

Test Your Knowledge

A 41-year-old patient with a BMI of 39 kg/m2 returns for a follow-up visit 3 months after initiating metformin. She is highly sensitive to her weight and has tried to implement lifestyle modifications, but is finding it difficult to make any meaningful changes in her diet or exercise routines. Her current A1C is 7.7%, with a target goal A1C<7%. In addition to discussing consideration of bariatric surgery, which drug class might you add? A. Thiazolidinedione B. Sulfonylurea C. DDP-4 inhibitor D. GLP-1 receptor agonist Follow the link to see the correct answer.

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Knowing Numbers Keeps Patients on Track

Received a phone call from someone I know. Has not yet come in for a visit. Just called to see if she qualified to come in for a visit. Woman, 68 years of age, denies history of diabetes, hypertension or other health problems, except being overweight. She stated, “Last year my weight was up. I went on a diet because my triglycerides were high, in the 600’s, but they came down to 140’s when I lost 30 pounds last year. I think I gained back about 10 pounds so that would be about 155 pounds now.” I asked her if she’s weighed herself. She said, no, not since I got off the program, but when I was on the program, I weighed daily. You know, I had holidays, travel, I was with a group, paid for the food, so ate what they all ate, then I just couldn’t get back on track.”

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #94: Lipid and Lipoprotein Metabolism, Hypolipidemic Agents, and Therapeutic Goals Part 6

Nicotinic acid (niacin) has been used for more than 50 years to lower LDL-C and TGs, and increase the level of HDL-C. Indeed, niacin is the most potent HDL-C-raising pharmacologic agent available. Of note, we still, at this late time in the life of niacin, do not have definitive evidence regarding its mechanism(s) at the molecular level.

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