Friday , October 20 2017

Question 825

She jokes that she “just can’t seem to lose that extra baby weight” after giving birth 3 years ago. However, her daughter recently started preschool, so she has been able to go to her new gym several times per week. In fact, one of the added bonuses of her membership is the free, weekly nutrition and exercise support groups. In addition to her routine labs, you order an A1C, which comes back elevated at 7.1%. This measurement is confirmed several days later. Based on Mrs. Hunter’s profile, you encourage lifestyle modifications and start metformin with an A1c target of <7%.

After four years of good glycemic control with metformin 1500 mg q day, Mrs. Hunter returns for her 6-month follow-up visit. At this time, her office A1C is 8.2% and she has gained 7 pounds. She is very concerned about her weight gain. If weight is a concern, what would be the best antiglycemic drug to add to her regimen?

Correct

Answer:  D. A GLP-1 receptor agonist

The use of GLP-1 receptor agonists is associated with modest-significant weight reduction. The other medications listed are either associated with weight gain or are weight neutral.

Reference(s):

Inzucchi S, et al. Management of hyperglycemia in type 2 diabetes: A patient-centered approach. Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2012; 35(6):1364-1379.

Incorrect