Often we see a great deal of misinformation in the care of patients with diabetes, and often this misinformation is centered around the role and choice of medications. Many patients, especially newly diagnosed patients, are prescribed medications that do not fit into the scheme of the ADA / AACE guidelines / best evidence based practices – for instance, starting on Januvia (sitagliptin) or Jardiance (empagliflozin) or Byetta (exenatide) as initial monotherapy without a compelling indication or reason.
In this discussion, please talk about how patients get put on these medications and why/how they should be transitioned to more evidence based treatments.
Now let’s consider the following case about thyroid disorders. A 69-year-old man goes to his family doctor because he has been feeling fatigued and lethargic. His doctor does a complete evaluation. This patient had a myocardial infarction and has a recurrent ventricular arrhythmia (treated with amiodarone). The patient’s TSH is elevated and his T4 is slightly decreased.
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