John S. is a 63-year-old Caucasian 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:
You explain John’s options for antihyperglycemic therapy. Which of the following answers most accurately describes the extraglycemic benefits of the different options? Correct Answer: a. The GLP-1 receptor agonists may improve endothelial function and reduce infarct size and the SGLT2 inhibitors are likely to improve arterial blood flow.
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
Antihyperglycemic Therapy
Jan 5, 2019
Correct
Incorrect