Clinical Approach to Medical Management of Type 2 Diabetes
Clinical Approach to Medical Management of Type 2 Diabetes
Clinical Approach to Medical Management of Type 2 Diabetes
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The Biguanides:<br />
Basic Characteristics <strong>of</strong> Metformin<br />
Mechanism: Decreases hepatic glucose production<br />
by activating AMP-kinase<br />
Power: Decreases HbA 1c ~ 1.5%<br />
Dosing:<br />
One <strong>to</strong> three times daily<br />
(aim for 2000 mg daily)<br />
Side effects: Diarrhea, nausea (start low), low B12<br />
Main risk: Lactic acidosis, very rare (1/3000<br />
patient-years)<br />
Limitations: Cr < 1.5 (M), < 1.4 (F),<br />
(Canada Cr cl > 60)
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