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Old 11-06-2021, 09:35 AM
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Originally Posted by Unregistered View Post
Like u say lo. High CV risk because added cardiovascular benefit.
Applicable to patient or not?
Nothing wrong with using su what. I rather a well controlled hba1c rather than some possibiliy phantom cardio benefit that might not apply to my patient. Sglt2 is a dollar per tablet lei. For my patient some of whom are cleaners or Ur admin staff making 1.x to 2.x k a month, it's not cheap. Some come in with valsartan, sglt2 , crestor AND fenofibrate given by their private gp and I go seriously?
Have some 良心la.
Problem sometimes is private GP cut back some meds. Eg no fenofibrate. Tell patient diet changes. Use SU.
But when the patient admitted to GS for cholecystitis and have blue letter referral to In Med then the hospital int med dr might say why never control Triglycerides? Who still uses SU? Lousy GP!

You either follow EBM or you dont. There is no oh by the this is cheaper affordable EBM that one is way too expensive EBM. One reason why I went back to OPS after my stint as private GP.

EBM is way to go and is correct. But it is expensive. OPS system helps manage the cost part for the patient. I want to do my best for the patiet. Not merely what they can afford.

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