New Onset Diabetes Mellitus

You have been following your patient for the past 2 years. You have worked with them to lose weight by changing lifestyle and nutritional habits. They continue to be overweight (body mass index [BMI] of 33) and have tried to cut down carbohydrate and fat intake, but now presents with polyuria, polydipsia, and an elevated random blood sugar of 164. You have ordered anHbA1c test in the past, and the values were less than 6.2%. However, the most recent test indicated an HbA1c greater than 7%. They are not on any medications, but does have a sulfa allergy.

You officially have enough evidence to officially start treating this patient for Type II Diabetes Mellitus.  Their 3 P symptoms, their random  blood sugar (BS), and A1C are all evidence ofT2DM.

Answer the following questions. 

  1. What is the first medication you would prescribe? Discuss how you determined which one to give first and how you based this decision on specific factors.
  2. What education regarding medication management would you need to do?