This article originally posted 03 February, 2012 and appeared in GLP-1 Agonist, Issue 611
SPECIAL GLP-1 TEST YOUR KNOWLEDGE, Part 1
Scott is a 57-year-old white male who has been diagnosed with type 2 diabetes mellitus (T2DM) for 4 years.
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Upon diagnosis, with a glycosylated hemoglobin (A1c) level of 7.3%, he was initiated on lifestyle modifications plus metformin 500 mg twice daily. Eventually his metformin was titrated up to 1000 mg twice daily. After his best attempts at diet, exercise, and adherence to metformin for 1 year, his A1c was down to 6.4%. Scott presents to you most recently, however, with a loss of glycemic control despite continued best efforts on his part. His A1c has climbed to 7.7%, and you decide it is time to initiate another antihyperglycemic agent in addition to his metformin. At this visit his body mass index is 32 kg/m2, and his waist circumference is 46 inches.
Question 1: Which of the following represents the best choice as a next step for this patient, especially according to the American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE) algorithm for treatment of T2DM?
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