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t2dm patientcase

Jonny Nguyen

Created on February 12, 2024

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PATIENT CASE PRESENTATION: Type 2 diabetes melitus (T2DM)

Jonny Nguyen 2024 PharmD. Candidate University of Houston College of Pharmacy, P4 Preceptor: Rosemary Onuegbu Patient Care Service Manager Albertsons/Randall/Tom Thumbs (Southern Division)

INDEX

DIABETES

PATIENT CHOICE

PATIENT INFORMATION

STAT

PRESCRIPTION

NON-PHARMALOGICAL

DIAGNOSIS

INTERACTIONS

REFERNCE

MARKET

MECHANISM

DIABETES MELITUS

What puts me more at risk of having T2DM?

Chronic, metabolic disease characterized by elevated levels of blood glucose, which progressively worsen the heart, vasculature, eyes, kidneys, and nerves.

Here are some things that can increase your likelihood of having T2DM:

  • Genetic susceptibility
    • highest: Japanese, Hispanics, and Native Americans)
  • Aging
  • Medication
    • corticosteroids, antipsychotic, anti-retrovirals, progestin-only oral contraceptives
  • Unhealthy lifestyle
    • overeating, obesity (BMI>30), inactivity (sedentary)

MAIN FACTORS

  • Defective insulin secretion by pancreatic B-cells
  • Inability of insulin-sensitive tissue to respond to insulin

Galicia-Garcia U. Pathophysiology of Type 2 Diabetes Mellitus. International Journal of Molecular Sciences. 2020;21(17):1-34.

epidemiology

How has T2DM impacted our everyday families?

Emergency Department Visits: 579,000Physician Office Visits: 38.2 million (14.2%)Morbidity (Age: 20+): 16.2%Mortality:

  • Number of deaths: 103,294
  • Deaths per 100,000: 31.1
  • Ranked 8th in cause of death in the U.S.

CDC. FastStats - Diabetes. Centers for Disease Control and Prevention. Published 2019. https://www.cdc.gov/nchs/fastats/diabetes.html CDC. National diabetes statistics report. CDC. Published November 29, 2023. https://www.cdc.gov/diabetes/data/statistics-report/index.html

THE IMPACT

It's just sugar, whats the big deal?

Diabetes is a disease that can progressively worsen over time, leading to irreversible damages that will impact patients quality of life. Development of T2DM is contributed by the following organs: the pancreas (beta and alpha cells), liver, skeletal muscle, kidneys, brain, small intestines, and adipose tissues.

DIAGNOSIS

What lab values indicates T2DM?

American Diabetes Association (ADA) has set these criterias as diagnosis for T2DM. Patient qualifies if having any of the following:

  • A1C >6.5%+
  • Fasting Blood Glucose: >126 mg/dL (7 mmol/L)
  • 2 hour plasma glucose >200 mg/dL (11.1 mmol/L) during an oral glucose tolerance test, using a glucose load of 75g anhydrous glucose dissolved in water
  • In patients with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose >200mg/dL

American Diabetes Association. Diagnosis | ADA. diabetes.org. Published 2023. https://diabetes.org/about-diabetes/diagnosis

MEDICATION CLASS

What medications can I purchase?

These are the medications along with class that can help lower glucose levels:

  • Endogenous medications
    • Biguanides
    • Sodium-Glucose Transporter-2 inhibitor (SGLT2)
    • Glucagon-Like Peptide-1 Receptor Agonist (GLP1RA)
    • Dipeptidyl Peptidase IV (DDPIV) inhibitors
    • Sulfonylureas
    • Thiazolidinedione
  • Exogenous medications
    • Insulin
      • Rapid, Short, Intermediate, Long

(Metformin)

(Empagliflozin)

(Liraglutide)

(Linagliptin)

(Glipizide)

(Pioglitazone)

COMORBID CONDITION?

Well, which one do you recommend?

Based on other risk factor, we can help you determine what can be the most appropriate for you! Your first option should be based upon patient-specific factors!

Samson SL, Vellanki P, Blonde L, et al. American Association of Clinical Endocrinology Consensus Statement: Comprehensive Type 2 Diabetes Management Algorithm - 2023 Update. Endocrine Practice: Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2023;29(5):305-340. doi:https://doi.org/10.1016/j.eprac.2023.02.001 ‌

JUST GLUCOSE+WEIGHT GOALS?

Well, which one do you recommend?

Furthermore, these are some other things to consider when choosing your medication!Glucose lowering efficacy:

  • Very High: Dulaglutide (high-dose), Semaglutide, Tirzepatide, Combination Thearpy
  • High: GLP-1RA (not listed above), Metformin, SGLT2i, Sulfonylurea, TZD
  • Intermediate: DPP-4i
Weight loss effect:
  • Very High: Semaglutide, Tirzepatide
  • High: Dulaglutide, Liraglutide
  • Intermediate: GLP-1RA (not listed above), SGLT2i
  • Intermediate: DPP-4i, Metformin
Patient is allowed to add additional agents based on patient-specific factors including: comorbidities, risk, glycemic management needs, convience, cost and access

Do not combine DPP-4i, GLP-1RA, and/or Tirzepatide (GLP-1/GIP RA)

Samson SL, Vellanki P, Blonde L, et al. American Association of Clinical Endocrinology Consensus Statement: Comprehensive Type 2 Diabetes Management Algorithm - 2023 Update. Endocrine Practice: Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2023;29(5):305-340. doi:https://doi.org/10.1016/j.eprac.2023.02.001 ‌

Samson SL, Vellanki P, Blonde L, et al. American Association of Clinical Endocrinology Consensus Statement: Comprehensive Type 2 Diabetes Management Algorithm - 2023 Update. Endocrine Practice: Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2023;29(5):305-340. doi:https://doi.org/10.1016/j.eprac.2023.02.001 ‌

PATIENT INFORMATION

PATIENT PROFILE

Name: T.C. Age: 90 Gender: F Allergies: No Known Allergy

COMORBID CONDITIONS:

  • Cardiovascular disease
  • Diabetes
  • High Blood Pressure
  • High Cholesterol

  • High Potassium
  • Irritable Bowel Syndrome (IBS)
  • Nerve Pain
  • Stroke

PRESCRIPTION

DRUG-DRUG INTERACTION

MyEndoConsult. Mechanism Of Action Of GLP-1 Agonists - My Endo Consult. MyEndoConsult. Published June 1, 2023. https://myendoconsult.com/learn/mechanism-of-action-of-glp-1-agonists/

What's the problem? Shouldn't it be doing double the work?

THE JUSTIFICATION

ADA recommends against combining DPP-4 inhibitors and GLP-1 receptor agonists in patients with diabetes.

  • Studies have shown that it is unlikely to provide clinical beneift
  • It is not cost effective
  • Taking both product simultaneously may increase risk of side effect
The next slide should help you pick which one is best for you!

ONCE WEEKLY INJECTION

MACE: Major adverse cardiovascular event **: Benefit for renal endpoints in cardiovascular outcomes trial, driven by albuminuria outcomes

NON-PHARMALOGICAL CARE

Besides medication, what else can I do?

Here are some options you can look at!

  • Medication Nutrition Thearpy
  • Weight management
  • Physical activity
  • Smoking cessation
  • Diabetes for self-management education and support
  • Psychosocial care

White E. Treatments for Diabetes (Nonpharmacologic). Endocrinology Advisor. Published June 28, 2023. https://www.endocrinologyadvisor.com/ddi/treatments-for-diabetes-nonpharmacologic/#:~:text=4-

THE ACTION PLAN
  • DISCONTINUE:
    • Linagliptin (Tradjenta) 5mg tablet by mouth daily
  • CONTINUE:
    • Dulaglutide 3mg/0.5ml; inject 3mg under the skin weekly
  • CONSIDERATION:
    • MOST LIKELY NOT START: Metformin 500mg tablet by mouth daily - patient can have poor renal function
    • START: Empagliflozin (Jardiance) 10mg by mouth daily
    • INCREASE: Dulaglutide, inject 4.5mg under the skin weekly

REFERENCE

  1. Galicia-Garcia U. Pathophysiology of Type 2 Diabetes Mellitus. International Journal of Molecular Sciences. 2020;21(17):1-34.
  2. CDC. FastStats - Diabetes. Centers for Disease Control and Prevention. Published 2019. https://www.cdc.gov/nchs/fastats/diabetes.htmlCDC. National diabetes statistics report.
  3. CDC. Published November 29, 2023. https://www.cdc.gov/diabetes/data/statistics-report/index.html
  4. American Diabetes Association. Diagnosis | ADA. diabetes.org. Published 2023. https://diabetes.org/about-diabetes/diagnosis
  5. Samson SL, Vellanki P, Blonde L, et al. American Association of Clinical Endocrinology Consensus Statement: Comprehensive Type 2 Diabetes Management Algorithm - 2023 Update. Endocrine Practice: Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2023;29(5):305-340. doi:https://doi.org/10.1016/j.eprac.2023.02.001
  6. MyEndoConsult. Mechanism Of Action Of GLP-1 Agonists - My Endo Consult. MyEndoConsult. Published June 1, 2023. https://myendoconsult.com/learn/mechanism-of-action-of-glp-1-agonists/
  7. White E. Treatments for Diabetes (Nonpharmacologic). Endocrinology Advisor. Published June 28, 2023. https://www.endocrinologyadvisor.com/ddi/treatments-for-diabetes-nonpharmacologic/#:~:text=4-