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Endocrinology

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Question:

How is tx of DM?

Author: H K



Answer:

Lifestyle behaviors and meds. Aiming to maintain glycemia and weight (by diet and exercise) Medications include those in case of CV risk (in case of HF give SGLT2i, in case of CKD give SGLT2i or GLP-1 RA if SGLT2i not tolerated, if HbA1C above normal give both, in case of high risk of CV complication give GLP-1RA or SGLT2i or both in case A1C above target) In case of maintenance of glycemia if HbA1C above normal(for glycemic management give metformin, very high efficacy (dulaglutide, semaglutide, tirzepatide, insulin combination oral or injectable) high efficacy for metformin, SGLT2i, GLP1-RA...) Weight loss if HbA1C above normal (very high efficacy (semaglutide and tirezepatide), high efficacy (dulaglutide and liraglutide) intermediate (GLP1RA and SGLT2i) neutral metformin and DPP-4i


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H K
H K