Problem
Your patient, a 47-year-old male was diagnosed with Type 2 diabetes 12 months ago and is currently treated with lifestyle and metformin 1g twice daily. He lives alone, has had a previous myocardial infarction at the time of diabetes diagnosis but no documented evidence of heart failure. He has an HbA1c of 8% (64 mmol/mol), eGFR 70 mL/min/1.73 m2 and BMI 33kg/m2. He is also prescribed atorvastatin 80mg, bisoprolol 5mg and ramipril 10mg.
With reference to published guidelines, consensus documents and evidence discussed during the module:
• Justify whether you feel his glycaemic control should be intensified at this stage and if so, discuss what glycaemic target you would aim to agree with him and why.
• List the additional ORAL hypoglycaemic agents you would consider recommending to him.
• Outline the mode of action, benefits and potential risks of each treatment type to help him decide on additional therapy.
• If there are therapies which you would not recommend, document these and explain why.
• Allowing for joint decision making and based on individualization of therapy, present a detailed case for which drug you finally recommend he take. Ensure this recommendation is referenced to your chosen guideline/guidance.
The response must include a reference list. One-inch margins, double-space, Using Times New Roman 12 pnt font and APA style of writing and citations.