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Management of an Adult With Type 2 Diabetes With Antidiabetic Medications: A Case Scenario

Slide: 24 of 26

Informed Decisionmaking: Treatment Options

You then discuss with him the treatment options going forward. Which of the following lines of information do you use to help inform his decision?

Discussion of Answers:

A. Incorrect. Explanation: All of these options are correct.

B. Incorrect. Explanation: All of these options are correct.

C. Incorrect. Explanation: All of these options are correct.

D. Correct. Explanation: Evidence suggests that several combination therapies have similar efficacy at reducing HbA1c. The issue of whether the patient will accept the trade-off of visible fat weight gain is one that he himself needs to make on the basis of a frank discussion of the evidence.  There is moderate strength evidence that metformin + a second-generation sulfonylurea will have a more favorable effect on weight when compared to metformin + a thiazolidinedione by -0.9 kg. There is also low strength evidence that adding a GLP-1 agonist or DPP-4 inhibitor may have a more favorable effect in weight when compared to the combination of metformin + thiazolidinedione.