Question

• If patients not able to achieve A1C’s <7%, do you think it was reasonable to add insulin on top of these agents? What would you recommend as the next medication to add on top of Metformin + DPP-4 inhibitors?
• Are A1C’s an accurate representation of sugar control for patients all across the world?
• find a primary lietrature study study where DPP-4 inhibitors provides cardiovascular benefits

Answer 1

1). A1c can be reduce by diet and exercise if it doesnt work doctor can prescribe you metformin, miglitol, or insulin.

Incretins help the body produce more insulin but sometime it can be produced by medicine like

Sitagliptin,Sitagliptin + Metformin and Alogliptin etc.

2).The measurement of A1C equals the assessment of hundreds (virtually thousands) of fasting glucose levels and also captures postprandial glucose peaks; therefore, it is a more robust and reliable measurement than FPG and/or 2-h OGTT plasma glucose.

3).According to American Diabetes Association (ADA) 2016 guidelines,DPP-4 inhibitors are considered as second line oral medications for treatment of DM2. Currently available DPP-4 inhibitors are alogliption, saxagliptin, sitagliptin, linagliptin, and vidagliptin. The cardiovascular (CV) outcome trials were conducted using alogliptin, saxagliptin and sitagliptin; a phase 4 trial with linagliptin is ongoing for individuals with DM2