MEDizzy - A 56-year-old man was found to have the following serum

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Drugs for Diabetes Mellitus

A 56-year-old man was found to have the following serum values during a routine clinic visit: fasting blood glucose 146 mg/dL (normal 70−110 mg/dL), glycated hemoglobin (HbA1c) 7.4% (normal 6%), total cholesterol 160 mg/dL (normal < 200 mg/dL). The patient had been suffering from type 2 diabetes for 6 years, and his disease was well controlled with diet and metformin until the most recent visit. The patient was otherwise healthy, and physical examination was unremarkable. All tests were confirmed in a second exam. Which of the following would be the most appropriate next step in the management of the patient’s disease?

ExplanationThe patient’s serum values indicate that the control of his diabetes was no longer adequate. When a single oral antidiabetic agent fails to control the disease, a second oral agent should be added to the therapy. Many combinations of antidiabetic agents can be used. The key is that they should have different mechanisms of action. Because the patient was on metformin, the addition of a sulfonylurea is appropriate.