Introduction
The patient under consideration presents with diabetes mellitus and a body mass index (BMI) of 35. He uses basal and rapid-acting insulin, metformin, and statins for glucose and cholesterol control, as well as Lisinopril and steroid cream for hypertension and intermittent eczema. Considering the patient’s BMI, it can be stated that his weight loss goals are not met.
Discussion
The following families of antidiabetic drugs are considered adjunctive medication: α-glucosidase inhibitors, amylin agonists, incretin mimetics, SGLT2 antagonists, glucagon-like peptide 1 receptor agonists, insulin secretagogues and sensitizers, and biguanides (Padhi et al., 2020). These types of medications are common in the treatment of type II diabetes. Most of these medications, including biguanides, SGLT2 antagonists, incretin mimetics, and glucagon-like peptide 1 receptor agonists, are associated with weight loss (Padhi et al., 2020). Such medications as insulin secretagogues and sensitizers can lead to weight gain and should not be offered to the client (Padhi et al., 2020). Furthermore, as the patient refuses injectable medications, glucagon-like peptide 1 receptor agonists and incretin mimetics should be excluded from the list (Alexopoulos & Buse, 2019). The remaining drugs on the list can be taken orally.
In addition, the patient’s concerns about cancer and gastrointestinal (GI) issues should be considered. According to Funch et al. (2021), glucagon-like peptide 1 receptor agonists are most commonly linked to the development of medullary thyroid cancer (Cersosimo et al., 2021; Funch et al., 2021). However, these medications are already excluded due to being delivered via injection. Furthermore, recent research suggests that metformin, the drug belonging to the biguanides family of medications, should be considered an anti-cancer agent (Nozhat et al., 2022).
Conclusion
However, it should be noted that biguanides, α-glucosidase inhibitors, and amylin agonists are associated with GI distress due to the absorption of carbohydrates occurring in the small intestine (Padhi et al., 2020). However, the GI side effects can be managed when the dose is appropriately adjusted.
References
Alexopoulos, A., & Buse, J. B. (2019). Initial injectable therapy in type 2 diabetes: Key considerations when choosing between glucagon-like peptide 1 receptor agonists and insulin. Metabolism, 98, 104–111. Web.
Cersosimo, E., Solis-Herrera, C., & Triplitt, C. (2021). The evidence behind early aggressive multi-drug treatment in type 2 diabetes. Trends in Diabetes and Metabolism, 4(1), 1–11. Web.
Funch, D., Mortimer, K., Ziyadeh, N. J., Seeger, J. D., Zhou, L., Ng, E., Ross, D., Major-Pedersen, A., Bosch-Traberg, H., Gydesen, H., & Dore, D. (2021). Risk of thyroid cancer associated with use of Liraglutide and other Antidiabetic drugs in a US commercially insured population. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 14, 2619–2629. Web.
Nozhat, Z., Zarkesh, M., Baldini, E., Mohammadi-Yeganeh, S., Azizi, F., & Hedayati, M. (2022). Antineoplastic activity of an old natural Antidiabetic biguanide on the HumanThyroid carcinoma cell line. Anti-Cancer Agents in Medicinal Chemistry, 22(4), 713–720. Web.
Padhi, S., Nayak, A. K., & Behera, A. (2020). Type II diabetes mellitus: A review on recent drug based therapeutics. Biomedicine & Pharmacotherapy, 131, 1–23. Web.