QuestionSBA
QuestionChoice
Whilst sulfonylureas, such as gliclazide, may be considered in the management of type 2 diabetes, metformin is usually started before them.
10002403
b
Start sulfonylurea
QuestionChoice
As this patient is symptomatic and his symptoms have not improved with lifestyle changes alone, it is important to commence medical therapy.
10002406
e
No further management required
QuestionChoice
Whilst insulin therapy may be considered in the later stages of type 2 diabetes, metformin is the recommended first-line medication after initial diagnosis.
10002405
d
Start insulin
QuestionChoice
In patients with type 2 diabetes who do not respond to lifestyle changes alone, medical therapy should be commenced. In the absence of contraindications, metformin is usually the first medication started for type 2 diabetes.
10002402
a
Start metformin
QuestionChoice
As the patient's HbA1c levels have been raised on 2 occasions, it is important to start medical therapy, rather than repeating the test again.
10002404
c
Repeat HbA1c after 3 months
QuestionComment
The patient is symptomatic with polyuria and polydipsia - is that not an indication to provide them with sulphonylurea until their BG is controlled? Or is it because that's in the past and it's safe to assume the patient is no longer 'symptomatic' 
25421
User
subscriber
beggingforapass
Concept
Chapter
2693
4037
Type 2 Diabetes Mellitus
Topic
162
General practice
13027
A 68-year-old male presents to General Practice with symptoms of tiredness, increased thirst and frequent urination. A glycated haemoglobin (HbA1c) test is found to be elevated at 54 mmol/L (normal range 20-42 mmol/L). The patient is advised to make lifestyle changes, but a repeat HbA1c measured 3 months later remains elevated at 56 mmol/L.


What should be the next step in the management of this patient?
a