Fitzgerald Nurse Practitioner (NP) Pre-Test Practice

The best approach for treating poorly controlled diabetes, particularly in patients with a high BMI, is to add another class of oral medication. This strategy is often employed because it allows for a more robust management of blood glucose levels while minimizing the side effects that may occur with increasing the dosage of a single medication or initiating insulin therapy.

Adding another class of oral antihyperglycemic medication can help target different pathways of glucose regulation in the body. For example, combining metformin with a medication from a different class, such as a GLP-1 receptor agonist or an SGLT2 inhibitor, can lead to improved glycemic control and weight management, which is particularly important in patients with obesity.

This multifaceted approach can allow for a reduction of blood glucose while also addressing weight gain issues associated with other diabetes medications. It is also generally better tolerated and can be performed while continuing to encourage lifestyle modifications, which are crucial for diabetes management but may not be sufficient on their own if blood glucose levels remain poorly controlled.