Clinical QuickieEndocrine/Metabolic
Diabetes Management
Treat the patient's glucose pattern, comorbidities, and risk — not just the A1c.
Start with the pattern
A1c, fasting/postprandial glucose, CGM/SMBG, hypoglycemia, symptoms, and medication adherence tell different parts of the story.
Choose therapy with comorbidities in mind
ASCVD, heart failure, CKD, obesity, hypoglycemia risk, cost, renal function, and patient preference can change the preferred medication pathway.
Watch for treatment harm
Hypoglycemia, dehydration, GI intolerance, genital infections, volume issues, and medication interactions may matter more than a small A1c difference.
Reassess during transitions
Hospital discharge, steroid use, acute illness, weight loss, renal decline, and major dietary change can make a previously stable regimen unsafe.
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