Initial scenario Clinton is a 40-year-old African-American man, married with 4 children, who works as a foreman of a loa
Posted: Sat Jul 02, 2022 9:56 pm
Initial scenario
Clinton is a 40-year-old African-American man, married with 4children, who works as a foreman of a loading dock. He wasdiagnosed with T2DM 3 months ago. He weighs 220.5 lb and has a bodymass index (BMI) of 31.6 kg/m2. He is a current smoker. He is on noprescription medications. His current A1C level is 7.8%. His totaland LDL cholesterol concentrations are above normal. He complainsof sleep disturbance. His vitals: pulse: 55 bpm, respirations:22/min, BP: 148/92 mmHg.
Before answering question 3, review the following scenarioupdate.
Scenario update
Clinton is started on the following medications:
Clinton is counseled on his therapeutic targets for reducing therisks of diabetes complications:
Clinton understands that he must stop smoking and is referred toa smoking cessation program. He is referred to a registereddietitian for nutrition counseling. He agrees to begin walking 15minutes a day after dinner with his wife. He is counseled on thefact that diabetes is a progressive disease, that his medicationswill change over time, and that these changes will be discussedwith him.
Three months later:
Clinton has reduced smoking to twopacks/week. He thinks he has gained weight because he isusing hard candy and chewing gum in place of cigarettes.
3. How would you adjust Clinton's therapy to avoidfurther weight gain? Which is most likely to avoid further weightgain?
A. Discontinue metformin, start a sulfonylurea
B. Continue metformin, start a dipedtidyl peptidase-4 (DPP-4)inhibitor
C. Continue metformin, start a thiazolidinedione
D. Discontinue metformin, start a basal insulin
Clinton is a 40-year-old African-American man, married with 4children, who works as a foreman of a loading dock. He wasdiagnosed with T2DM 3 months ago. He weighs 220.5 lb and has a bodymass index (BMI) of 31.6 kg/m2. He is a current smoker. He is on noprescription medications. His current A1C level is 7.8%. His totaland LDL cholesterol concentrations are above normal. He complainsof sleep disturbance. His vitals: pulse: 55 bpm, respirations:22/min, BP: 148/92 mmHg.
Before answering question 3, review the following scenarioupdate.
Scenario update
Clinton is started on the following medications:
Clinton is counseled on his therapeutic targets for reducing therisks of diabetes complications:
Clinton understands that he must stop smoking and is referred toa smoking cessation program. He is referred to a registereddietitian for nutrition counseling. He agrees to begin walking 15minutes a day after dinner with his wife. He is counseled on thefact that diabetes is a progressive disease, that his medicationswill change over time, and that these changes will be discussedwith him.
Three months later:
Clinton has reduced smoking to twopacks/week. He thinks he has gained weight because he isusing hard candy and chewing gum in place of cigarettes.
3. How would you adjust Clinton's therapy to avoidfurther weight gain? Which is most likely to avoid further weightgain?
A. Discontinue metformin, start a sulfonylurea
B. Continue metformin, start a dipedtidyl peptidase-4 (DPP-4)inhibitor
C. Continue metformin, start a thiazolidinedione
D. Discontinue metformin, start a basal insulin