Your patient, a 47-year-old male was diagnosed with Type 2 diabetes 12 months ago and is currently treated with lifestyle and metformin 1g twice daily. He lives alone, has had a previous myocardial infarction at the time of diabetes diagnosis but no documented evidence of heart failure. He has an HbA1c of 8% (64 mmol/mol), eGFR 70 mL/min/1.73 m² and BMI 33kg/m2. He is also prescribed atorvastatin 80mg, bisoprolol 5mg and ramipril 10mg.
With reference to published guidelines, consensus documents and evidence discussed during the module:
- Justify whether you feel his glycaemic control should be intensified at this stage and if so, discuss what glycaemic target you would aim to agree with him and why.
- List the additional ORAL hypoglycaemic agents you would consider recommending to him.
- Outline the mode of action, benefits and potential risks of each treatment type to help him decide on additional therapy.
- If there are therapies which you would not recommend, document these and explain why.
- Allowing for joint decision making and based on individualization of therapy, present a detailed case for which drug you finally recommend he take. Ensure this recommendation is referenced to your chosen guideline/guidance.
Points of clarification
- There are five sections to this assignment and your answer should cover them all.
- Focus only on his glycemic management in this assignment.
- 50% of the marks are for analysis and evaluation so it is important for you to demonstrate this in each section of the assignment., not less 2000 word
- refrance should be harvard