A man came to the doctor to control DM which he had suffered for 10 years. From the results of laboratory examinations, it was found that GDP was 150 mg/dl GD2PP 210 mg/dl. The patient has been taking metformin 3x500 mg. from the TTV examination results found BP 160/90 mmHg, RR 20x/minute HR 80x/minute afebrile temperature. BB 70 kg TB 175 cm. the doctor decided to add one class of anti-diabetic drugs. What drug should be avoided in this patient?

NEPHROLOGY

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Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]

A	Glimepiride
B	Pioglitazone
C	Linagliptin
D	Dapagliflozin
E	acarbosa

Explanation:

Detailed explanation-1: -Insulin is a hormone produced in the pancreas by special cells, called beta cells. The pancreas is below and behind the stomach. Insulin is needed to move blood sugar (glucose) into cells.

Detailed explanation-2: -Metformin has been used successfully since the 1950s as first line pharmacotherapy to treat people with type 2 diabetes. It is a biguanide that decreases blood glucose concentration by mechanisms different from those of insulin secretagogues, such as sulphonylureas, or exogenous insulin therapy.

Detailed explanation-3: -The level of hemoglobin A1c (HbA1c), also known as glycated hemoglobin, determines how well a patient’s blood glucose level has been controlled over the previous 8–12 weeks.

Detailed explanation-4: -Metformin is the most widely used drug, together with sodium-glucose co-transporters 2 (SGLT2) inhibitors, amylin analogues, glucagon-like peptide 1 (GLP-1) receptor agonists, and dipeptidyl peptidase-4 (DPP-4) inhibitors.

There is 1 question to complete.

CLINICAL MEDICINE

MEDICINE

NEPHROLOGY