Question

1. Treatment for type 2 diabetes when the target A1C has not been maintained over the last 3 months on metformin?

Answer 1

Tye HbA1C level when it is above 6 is considered to be diabetic and a range above it ,is an indicator that the blood sugar levels are not maintained in the normal levels in the last 3 months.

When the patient is on metformin and if target A1C is not achieved the following has to be done to the treatment therapy which is called as add on therapy and this can effectively bring the high blood glucose level into a normal range.Tyey are as following

• Sulphonylurea (eg., Glimipride,Glipizide,Tolazamide).This is the first prefffered choice of drug along with metformin in a poor diabetic control patient
• TZD (Thiazolidinidiones):Pioglytazone,Rosiglitazone (it stimulates the production of natural insulin )
• GLP 1RA :Liraglutide,exenatide,Dulaglutide (it increases the production of insulin)
• SGLT2 (Sodium Glucose Co Transporter) inhibitors:Canaglifozin,Ertuglyfozin,Dapaglyfosin (can be retaken with or without food))
• DPP4 inhibitors:Sitagliptin,Saxaglyptin (when metformin and sulphonylurea fails to meet target this drug is added on)