A 54-year-old man with type 2 diabetes has recently had an HbA1c reading of 60 mmol/mol. He is currently taking the maximum dose of gliclazide as he experiences frequent loose stools with any form of metformin. What additional treatment options would you suggest?
A 21-year-old male has successfully made lifestyle changes to lose weight, including diet and exercise. He has lost 10kg over the past 6 months, but his BMI today still measures 33 kg/m^2. He has no other medical issues and is not taking any regular medication. He expresses concern about the potential health risks associated with his excess weight and asks if medication could aid in his weight loss.
Which of the following options would be the most appropriate course of action for this patient?
– Trial an appetite suppressant such as sibutramine for 3 months and continue if effective.
– Consider orlistat as a potential treatment option.
– Advise against pharmacological treatment as the patient’s BMI is below 35 kg/m^2.
– Offer a referral for bariatric surgery as the patient is a strong candidate.
– Initiate oral thyroxine (T4) to increase the patient’s basal metabolic rate.
Note: According to NICE guidelines, orlistat can be considered for patients with a BMI of 28 kg/m^2 or more, provided they have other risk factors such as type 2 diabetes or hypertension. Safe prescribing is a key component of the MRCGP Applied Knowledge Test (AKT).
A 20-year-old male presents at your clinic with symptoms resembling the flu. He has recently been diagnosed with type 1 diabetes and seeks guidance on managing his diabetes during illness. What is one of the ‘sick-day rules’ that insulin-dependent diabetics should follow when they are sick?
A 38-year-old woman with a BMI of 34 kg/m^2 has lost 3 kg in the last month and is considering taking a weight loss medication. What is the main mechanism of action of orlistat?
Which of the following statements about dipeptidyl peptidase-4 inhibitors for managing type 2 diabetes mellitus is accurate?
A 47-year-old woman with type 2 diabetes mellitus is being evaluated for exenatide treatment. What is not included in the NICE guidelines for initiating or maintaining this medication?
Which of the following secondary causes of hyperlipidaemia lead to mainly hypercholesterolaemia instead of hypertriglyceridaemia?
Liam is a 27-year-old man with a history of depression and type 1 diabetes mellitus, for which he takes citalopram and insulin.
What substances should Liam avoid due to potential dangerous interactions with his medication?
What is the target blood pressure for a 55-year-old man with type 2 diabetes mellitus and no end-organ damage, based on a clinic blood pressure reading?
For elderly patients who fast during Ramadan, what is the correct approach to managing type 2 diabetes mellitus?