Peer Response to Nona

User Generated

zhebfb

Health Medical

Concorde Career College

Description

Peer Responses:

Considering that T2DM and hypertension are well managed, the treatment options for elevated A1c and elevated BMI include:

           Addition of a GLP-1 Receptor Agonist (e.g., dulaglutide, exenatide, or liraglutide): GLP-1 agonists have consistently shown effectiveness in improving glycemic control, particularly for patients with T2DM. This aspect means it is suitable for losing weight given the patient's high BMI of 32 kg/m2. They also have associated improvements in hemoglobin A1c levels, making the medication option relevant for the patient (Samuels et al., 2023). However, this treatment option may be unsuitable for the patient, considering the higher costs and potential adverse effects (Li et al., 2021). Furthermore, GLP-1 is usually administered intravenously, which may affect adherence.

           SGLT-2 inhibitors (empagliflozin or canagliflozin): Sodium-glucose cotransporter 2 (SGLT-2) reduces A1c by up to 1% and is a potent medication for glycemic control that promotes weight loss. As such, the medication is highly effective for the patient, considering her high BMI. Research has also shown that SGLT-2 can offer renal and cardiovascular benefits (Davis et al., 2021). Furthermore, the medications are available in oral form, which makes it easier for adherence purposes. However, drawbacks may arise when it comes to cost, as these medications can be relatively expensive. Their usage should also be closely monitored, as there is a risk of genital infections and renal function (Li et al., 2021).

           Metformin dosage adjustment: Adjusting the dosage upwards may help improve glycemic control and help reduce A1c further. Overall, metformin has a relatively lower risk of adverse effects and is well tolerated. Moreover, it may be pocket-friendly for the patient because she is already using it and has been adhering to instructions. However, on its own, it may not be effective in optimizing glycemic control. The dosage can be adjusted upwards to a maximum of 2550 mg/day for immediate release (Koufakis et al., 2021).

Local Resources for Assistance:

RxAssist patient assistance program center helps patients obtain free or low-cost medications and learn about the safety net programs available for those uninsured. This program is available at: https://www.rxassist.org/

Professional Prescription Advice (PPA) helps patients find free or nearly free medications if they are unable to afford prescribed medications. This program is available at: https://www.pparx.org/

Diabetes Foundation offers free education, financial assistance, and low-cost medications for patients with T2DM. This program is available at: https://www.diabetesfoundation.org/

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Explanation & Answer

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1

Nona Peer Response

Student’s Name
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Instructor’s Name
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2
Nona Peer Response
Hello Nona, your discussion on treatment options for managing elevated A1c and
BMI in patients with T2DM and hypertension is comprehensive and well-structured. The
inclusion of “G...


Anonymous
This is great! Exactly what I wanted.

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