Question #18 - klebsiella

[ArchivalUser]

A 55-year-old woman comes to the clinic after being diagnosed with type 2 diabetes mellitus during a routine screening performed at work. She is currently asymptomatic and denies any history of frequent urination. On physical examination, you note a normal blood pressure. Her heart, lungs, and the remainder of the physical examination are within normal limits. When you ask the nurse to weigh your patient, you note her body mass index (BMI) to be 34. What is the next step in the management of this patient?

(A) Begin intense insulin therapy
(B) Begin glipizide
© Begin pioglitazone
(D) Begin acarbose
(E) Begin metformin

[ArchivalUser]

Anyone??

[ArchivalUser]

Eee

[ArchivalUser]

metformin causes wt loss

[ArchivalUser]

(E) Begin metformin

Explanation:

In the obese patient with new-onset, type-2 diabetes mellitus, the initial therapy of choice is metformin. Of all the oral hypoglycemics, metformin is the only medication that results in weight loss and a more favorable lipid profile. Metformin works primarily by suppression of hepatic gluconeogenesis. As a result, this oral medication will never cause hypoglycemia as a side effect.