Weight Loss
Explaining the role of Mounjaro for Type 2 Diabetes
As a pharmacy doctor, you will hear buzz about new injectable Mounjaro (tirzepatide), the first "twincretin" for type 2 diabetes . Think of Mounjaro as similar to a glucagon-like peptide-1 (GLP-1) agonist, BUT it’s also a glucose-dependent insulinotropic polypeptide (GIP) agonist. More twincretins are in the works. GL…
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Type-2 Diabetes
Using metformin in diabetes patients with kidney disease
M etformin will be used in more diabetes patients with kidney disease as FDA labeling catches up with the evidence. We're used to avoiding metformin if serum creatinine is over 1.5 mg/dL for men or over 1.4 mg/dL in women due to fear of lactic acidosis. But lactic acidosis is EXTREMELY rare, even in kidney disease. And now labeling will base metformin dosing on…
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Type-2 Diabetes
Pharmacotherapy of type 2 diabetes
Overview ㅡ Effective treatment of type 2 diabetes is uniquely challenging because it encompasses management of lifestyle factors ( including diet, exercise, and weight control ), use of multiple oral or injectable medications, self-monitoring of blood glucose concentration, and surveillance and treatment for acute and chronic diabetic complications. Goals of Ther…
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Surgery
Preop mgmt of diabetes meds in pts undergoing surgery
Overview ㅡ The goal is to help prevent the blood glucose seesaw. Consider these strategies, but be aware, evidence is lacking for the best preoperative glucose targets or protocols for diabetes medications. Continue to recommend avoiding tight blood glucose control around surgery to limit hypoglycemia. Generally aim to keep glucose below 180 mg/dL or lean toward less…
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