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Type 2 Meds with Cardio Benefits

John S. is a 63-year-old white man with significant abdominal obesity, type 2 diabetes, hypertension, and dyslipidemia as well. On the basis of an exercise stress test, John was recently diagnosed with silent ischemia. John’s current medications include metformin, a DPP-4 inhibitor, an ACE inhibitor/HCTZ agent, a calcium channel blocker, a high-dose statin, and ezetimibe. John’s relevant physical exam and laboratory findings are as follows:

BMI: 34.8 kg/m2
Blood pressure: 140/86 mm Hg
HbA1C: 7.2%
Total cholesterol: 150 mg/dL
LDL-C: 79 mg/dL
HDL-C: 42 mg/dL
Triglycerides: 145 mg/dL
non-HDL-C: 118 mg/dL
eGFR: 65 mL/min/1.73 m2
ACR: 100 mg albumin/g creatinine

Which statement best describes the evidence supporting cardiovascular benefits of the antihyperglycemic agents available to treat John’s type 2 diabetes?

A. Further glucose reduction using any available agent should have similar cardiovascular disease benefit.
B. Thiazolidinediones increase the risk of heart failure and myocardial infarction in patients with type 2 diabetes.
C. Two approved GLP-1 receptor agonists have been shown to reduce mortality in patients with type 2 diabetes and cardiovascular disease.
D. Both GLP-1 receptor agonists and SGLT2 inhibitors affect cardiovascular risk through the same physiologic mechanisms.

Follow the link for the answer.

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Smart Pumps

With all the new insulin pump technology, do you feel that more patients, with either type 1 or type 2 using insulin, will move towards the smart pump rather than an insulin pump? Follow the link to see how you compare to your colleagues.

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Culture: Think About It

Man, 32 years of age, of Asian Indian descent, family history of type 2 diabetes, BMI-28,  blood pressure 142/84, WC-92cm visited for annual physical. Although the patient has not at this time been diagnosed with type 2 diabetes, the numbers and history were revealing that he is at increased risk. Not just because of his family history but also his BMI and WC. We discussed the importance of this person’s weight with him. In discussing this, we talked about making some changes in his meal plan and increasing his activity.

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Viswanathan Mohan 2018 Complete Interview

Viswanathan Mohan, PhD, MD, DSc is the chairman of Dr. Mohan's Diabetes Specialties Centre and president and director of the Madras Diabetes Research Foundation in Chennai, India. Dr. Mohan's centre is a WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control and IDF Centre of Excellence in Diabetes Care. The research foundation is an ICMR Centre for Advanced Research on Diabetes.

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