Joslin’s Diabetes Deskbook, Updated 2nd Ed., Excerpt #48: Pharmacotherapy of Type 2 Diabetes, Part 7
More Diabetes In Control May 27, 2014, 6:58 am
Richard S. Beaser, MD
This week’s excerpt covers the following topics:
The disadvantages of triple therapy
Which abnormality of the metabolic syndrome to treat first
When to start triple therapy
Why we need to be more aggressive in treating type 2 diabetes
Achieving a Proper Balance
When initiating and titrating combination therapy, it is important to strike a proper dosing balance between agents. For example, while medications that reduce insulin resistance usually do not cause significant hypoglycemia, when they are added to an insulin secretagogue, hypoglycemia is possible, particularly as the dose of medication that reduces insulin resistance is increased. In this instance, it is probably the insulin secretagogue that is precipitating the hypoglycemia, and it is the dose of this medication that should be reduced….
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