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They must be addressed individually
They must be addressed simultaneously
Decisions must be taken based on patients clinical condition
<10%
10-<25%
25-50%
>50%
Excellent
Good
Average
Below average
Age
Gender
Obesity
Duration of diabetes
Diet and Lifestyle
Stress
Any other
Weight loss
Dietary Approaches to Stop Hypertension (DASH)
Moderation of alcohol intake
Smoking cessation
Increased physical activity
Very effective
Moderately effective
Not effective
Sulphonylureas
DPP 4 inhibitors
SGLT2i
Alpha glucosidase inhibitors
GLP1RA
Better treatment outcomes
Improved patient compliance
Lower risk of hypoglycemia
Lesser need for titration
Increased affordability
Faster glycemic control
Slows the progression of underlying co-morbidities (CV, renal, etc.)
Reduced progression of micro-vascular complications
Improved compliance and adherence to treatment
Weight neutrality/ Weight loss
Improved renal profile
Improved HbA1c
Reduced risk of hospitalization
Coronary artery calcium score
NT pro BNP
Lipid profile
I do not routinely screen for ASCVD risk
<140 mmHg
<130 mmHg
<120 mmHg
<110 mmHg
<100 mmHg
<90 mmHg
<80 mmHg
<70 mmHg
ACE inhibitors
ARBs
Thiazides
Calcium channel blockers
In all prediabetics and Diabetic patients
In diabetic patients only
Only in patients with diabetes and risk factor for ASCVD
Only in patients with diabetes and history of previous atherosclerotic cardiovascular disease
In all diabetic patients
In patients with documented dyslipidaemia irrespective of ASCVD risk factors
Only in patients with ASCVD risk factors
Only in patients with previous atherosclerotic cardiovascular disease
The maximum tolerated dose of statin must be used
Statins must be discontinued
Alternative lipid lowering agents should be considered
The maximum tolerated dose of statin along with another lipid lowering agent
<70 mg/dL
<55 mg/dL
≥50% reduction from baseline
<100 mg/dL
Fibrates
Ezetimibe
Bempedoic acid
PCSK9i
Niacin
A combinatorial approach to address multiple pathophysiological mechanisms of hyperglycemia to achieve robust glycemic control.
An additional treatment that provides both glycemic and non-glycemic benefits, as the control of diabetes comorbidities is needed in most of the patients.
Reducing the occurrence of hypoglycaemia or weight gain, as recurrent distressing side effects of traditional antidiabetic agents reduces the morale of not only the patient but also the treating physician.
An oral treatment option that not only meets all of the pressing needs but additionally improves the compliance of the patients in need.
10 - <25%
25 – 50%
Yes
No
Can’t say
DPP4i
Others
All diabetic patients
Diabetic patients not controlled on medications
Diabetic patients with existing comorbidities
Urine albumin creatinine ratio (UACR)
Glomerular filtration rate
Reagent strip urine analysis for total proteins
Both eGFR & UACR
Once every year
Every 6 months
Every 3 months
Every month
In diabetic patients with heart disease to reduce the risk of hospitalizations
In diabetic patients with CKD to prevent the progression of CKD
In both a & b
I do not prefer finerenone in my practice
Every 4 months
Every year
≤6.5%
<7%
<8%
<7.5%
In patients having wide glucose excursions
Patients having uncontrolled HBA1c despite being on multiple antihyperglycemic agents
In Type 1 diabetes patients
In patients having recurrent episodes of hypoglycemia and receiving insulin
Must be advised in all morbidly obese patients
Must be recommended in patients where lifestyle modifications and pharmacological therapy fail
Must only be reserved for selected cases
Must not be recommended
Patients with severe diabetic chronic kidney disease
Patients with recurrent episodes of hypoglycaemia
Patients with recurrent episodes of diabetic ketoacidosis
Patients having incapacitating problems with exogenous insulin therapy