Tuesday , March 20 2018
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Treatment Options

Would you treat a patient with an A1c of 5.7-5.9%, who has diabetes in their family history and is a few pounds overweight with elevated cholesterol, with metformin along with diet and exercise, or just diet and exercise to get started? 1) Just diet and exercise to start 2) Diet and exercise along with metformin 3) Wait until their A1c is higher 4) Other Follow the link to share your opinion!

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It’s Allergy Season

Female, 58 years of age, type 2 diabetes, obesity, taking (Qsymia- phentermine/topamax) for weight loss, antihypertensive for hypertension, and metformin for glucose management. Blood pressure usually in the 120-130/70-80 range, glucose averages ~120, and was losing weight. Today’s b/p 170/90, random glucose 232, c/o tinnitus. Weight was up 5 pounds since last seen 3 months ago. It’s now allergy season. After further discussion, she told me she was started on a medrol dosepak, and on her own purchased and is taking an OTC allergy medication.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #70: Regulation of Glucose Metabolism in Liver Part 6 of 11

Acute regulation of gluconeogenesis: Prior to discovery of the transcriptional mechanisms described earlier, the control of hepatic glucose metabolism was examined in great detail on the basis of substrate, allosteric, and posttranslational modification. These factors alter gluconeogenic flux rapidly (seconds to minutes) and are a critical first response to increased glucose demand.

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