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Published in Obesity, Metabolic Syndrome, and Prediabetes

Expert Opinion / Cases · August 29, 2018

Patient With CV Co-morbidities and Adverse Events to Metformin and Glyburide: Next Steps?

Silvio Inzucchi MD

 

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Silvio Inzucchi MD

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  • santhanam gopal

    Aug 31, 2018

    why not no peak long acting nsulin

  • Jeffrey Jakob

    Sep 13, 2018

    Add SGLT2, based on guidelines, Empagliflozin. Depending on Edema level, possibly reduce, discontinue Pioglitazone.

  • Medhat Ghali

    Jan 12, 2019

    Stop glyburide due to associating hypoglycemia, we cannot start SGT2 inhibitors as eGFR less than 45ml/ min/ 1. 73m2 ( 35) . It is better to add Liraglutide 1.2 mg sci /day or another GLP agonist dulagutide 1.5 mg once weekly . Stop repaglinides also.

  • Medhat Ghali

    Jan 12, 2019

    It is better to stop pioglitazone due to cardiomegally and hypokinesia .we can introduce metformin 500 mg /day with follow up .use maximum intensity statin.

  • Medhat Ghali

    Jan 12, 2019

    It is better to stop pioglitazone due to cardiomegally and hypokinesia .we can introduce metformin 500 mg /day with follow up .use maximum intensity statin.

  • Medhat Ghali

    Jan 12, 2019

    Liraglutide 1. 2 mg /day is the best alternative anti diabetic with metformin 500 mg/day and can raise metformin up to maximum 1000 mg /day .

  • Hieu Truong

    Jan 18, 2019

    D/c piogliatazone and repaglinide , start Soliqua  or Xutrophy

  • Muhammad saleem

    Jul 26, 2019

    Do not start metformin,it is c/I after 1.5mg/dl creatinine,stop pioglitazone SGLT2 is safe in cv evevent or start liraglutide in low dose..

  • bendib samir

    Feb 27, 2020

    Discontinue pioglitazone .glyburide,can add Metformin 500mg and aGLP1 to diminish cardiovascular and renal complications.start a station.

  • Feb 08, 2025

    Pending Moderator approval.
    Delete

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