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  #2268 (permalink)  
Old 11-06-2021, 12:02 AM
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Originally Posted by Unregistered View Post
Btw empagliflozin can be first line.
Since 2019, ESC/EASD can be first line for empa for patients with high cv risk.

Sglt2i is critical.

Some of the ops rp not sure whether fm or not.
Seem to by pass sglt2i. Then go straight to sulphonylurea, not good.

Dude that guy so fat already, insulin resistance ++ , su and insulin will worsen the weight.

They shld keep up to date with the literature.
Cost is a big factor when it comes to prescribing- both in OPS and private. Hence this EBM stuff doesn't really work in practice. Especially so when you will have a lot of differing advice depending who you talk to. Obviously the patients who are not rich and cannot afford expensive medicines will go with the doctor who offers Metformin first. And they will also believe when they are told the Dr who suggested Sglt2i as first line "only wants to make money".
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