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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #93: Lipid and Lipoprotein Metabolism, Hypolipidemic Agents, and Therapeutic Goals Part 5

Diet and lifestyle modification: Appropriate lifestyle interventions involving diet and exercise can lead to weight loss, and since obesity is a major contributor to the IR and T2DM, weight loss should provide significant benefits to individuals with these problems. The Diabetes Prevention Program demonstrated that a 6% weight loss and the addition of two hours of exercise per week was associated with a 58% reduction in the incidence of new T2DM in a group with IGT. Similar results were obtained in the Finnish Diabetes Prevention Study using similar interventions.

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Which Insulin Do You Choose?

Test Your Knowledge

One of your patients is a 3-state regional salesman who has a fairly unpredictable work schedule. When he gets hungry while on the road, he tends to eat at the first restaurant he sees. For the past 3 months, he has managed his type 2 diabetes with metformin, glipizide, and glargine. Despite this regimen, his current A1C is 7.8%. You are in agreement that he needs to add a bolus insulin dose to his regimen. Which type of insulin would be the most appropriate choice? 1. Rapid-acting insulin analogues 2. Premixed insulin 3. Long-acting insulin analogues 4. Intermediate-acting insulin Follow the link to see the correct answer.

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Type 2 Drug Preferences

Which new drug do you prefer for a second-line therapy for a patient with type 2 patient diabetes? 1) GLP-1 Agonist 2) SGLT-2 Inhibitor 3) Long-acting insulin 4) TZD 5) Other Follow the link to share your response.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #92: Lipid and Lipoprotein Metabolism, Hypolipidemic Agents, and Therapeutic Goals Part 4

Therapeutic approaches to the dyslipidemia of insulin resistance and type 2 diabetes mellitus -- Key points: The rationale for treating the diabetic dyslipidemia is clear, it is associated with significantly increased risk of cardiovascular events.Weight loss, exercise, and diet modifications are key to successful treatment of all of the lipid abnormalities in patients with T2DM. Statins are the mainstay of therapy—they lower LDL cholesterol up to 50%, lower triglycerides about 15–25%, and have minimal effects of HDL cholesterol levels.

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