QuestionSBA
QuestionChoice
Thiazolidinediones increase insulin sensitivity of muscle and adipose tissue. An example of a drug in this drug class is pioglitazone. These drugs can be used as part of second-line therapy for diabetes but are not the appropriate choice for a patient with established cardiovascular disease.
10028032
b
Increases insulin sensitivity of muscle and adipose tissue
QuestionChoice
Insulin stimulates glucose uptake by insulin-sensitive cells and is used in the management of Type 1 and Type 2 diabetes. It is not an appropriate management choice in this situation.
10028034
d
Stimulates glucose uptake by insulin-sensitive cells
QuestionChoice
SGLT-2 inhibitors should be started as this patient has established cardiovascular disease. SGLT-2 inhibitors work by blocking the sodium-glucose transporter in the kidney, thus increasing urinary excretion of glucose.
10028031
a
Blocks renal sodium-glucose transporter
QuestionChoice
Dipeptidyl peptidase-4 (DDP-4) inhibitors reduce the inactivation of incretins. An example of a drug in this class is sitagliptin. These drugs can be used in the second-line therapy of diabetes.
10028033
c
Reduces the inactivation of incretins
QuestionChoice
Oral biguanides such as metformin inhibit hepatic gluconeogenesis. This patient is already on metformin.
10028035
e
Inhibits hepatic gluconeogenesis
Concept
Chapter
2693
6027
Diabetes
Topic
133
Endocrinology
18004
A 42-year-old man with type 2 diabetes presents to the GP with symptoms of dizziness and fatigue. He has a past medical history of a myocardial infarction.

His HbA1c is 65 mmol/mol. He is currently taking metformin for his diabetes.

What is the mechanism of action of the most appropriate medication to add in this situation?
a