General Internal Medicine

Diabetes

Questions discussed in this category

Do 5HT4 agonists such as Metoclopramide actually lead to improvement in symptoms for patients with diabetes related gastroparesis?

1 Answer available

In patients with MASLD, would you consider management with off-label metformin, pioglitazone (despite weight gain risk), GLP-1 RA, or simply intensify lifestyle and monitor?

If you prefer monitoring strategy, how frequently do you repeat labs and what is your referral thresholds to hepatology if you're practicing in primar...

1 Answer available

How do you approach managing patients with diabetic kidney disease and proteinuria who develop hypoglycemia after initiation of a SGLT2 inhibitor?

2 Answers available

How do you counsel someone about metformin use for type 2 diabetes mellitus who is also on a GLP-1 agonist and achieved goal HbA1c, but prefers not to be on metformin anymore?

2 Answers available

When should metformin be stopped before surgery and when is it considered safe to resume?

1 Answer available

How would you manage a patient who presents with hair loss that began after they started a GLP-1 inhibitor?

1 Answer available

What is your approach to the use of GLP-1 agonists in older adults with diabetes with or at risk of sarcopenia?

3 Answers available

How many days prior to surgery do you recommend stopping SGLT2 inhibitors and when is it safe to resume therapy?

2 Answers available

How should clinicians balance the use of finerenone with other heart failure treatments like SGLT2 inhibitors, considering their glycemic benefits?

Butt et al., PMID 39818225

2 Answers available

How many days prior to elective major surgery do you recommend holding oral GLP 1 R agonist therapy?

4 Answers available

How do you interpret the presence of GAD antibody in a middle-aged patient with diabetes when all other type 1 diabetes antibodies are absent?

2 Answers available

What is the recommended approach to treating severe constipation in patients on GLP1 R agonist therapy?

1 Answer available

Would you start once-weekly tirzepatide over once daily basal insulin in a patient with Type 2 diabetes with inadequate control on oral antihyperglycemia drugs?

Kamrul-Hasan et al., PMID 39672540

1 Answer available

What is the preferred first-line non-insulin agent in patients with ketosis-prone diabetes during "remission" and evidence of preserved beta cell function?

2 Answers available

Besides treadmill, what other exercises may be considered for post-exercise ABIs, and are their diagnostic parameters identical to standard post-exercise ABIs?

1 Answer available

Do you recommend routinely monitoring pancreatic markers such as amylase and lipase while receiving GLP1 R agonist or dual agonist therapies to determine their risk of pancreatitis?

2 Answers available

Should we be more cautious with the use of GLP 1 R agonist therapy in patients with Type 1 diabetes mellitus and obesity given the increased risk of cardiovascular disease with high body weight variability?

Prattichizzo et al., PMID 39468384

1 Answer available

Is there a role for use of GLP1 R agonist or dual agonist therapy for management of post bariatric hypoglycemia and dumping syndrome?

1 Answer available

When managing patients with suspected MASLD, what specific criteria or findings would prompt you to refer them to hepatology?

1 Answer available

Should GLP1 R agonists be used as first line glucose lowering agents in patients with ESKD and DM2?

1 Answer available

Is ABI (Ankle Brachial index) lower limb arterial doppler not recommended if patient already has arterial stents in the legs, and if so, what other imaging modality would you consider as first-line?

1 Answer available

Papers discussed in this category

The New England journal of medicine, 2023 Nov 11

Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes.

European heart journal, 2016-07-14

A randomized controlled study of finerenone vs. eplerenone in patients with worsening chronic heart failure and diabetes mellitus and/or chronic kidney disease.

The New England journal of medicine, 2024 Sep 01

Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction.

Circulation, 2024 Sep 28

Effects of the Nonsteroidal MRA Finerenone With and Without Concomitant SGLT2 Inhibitor Use in Heart Failure.

Diabetes care, 2016-11

Randomized Controlled Study of Metformin and Sitagliptin on Long-term Normoglycemia Remission in African American Patients With Hyperglycemic Crises.

Endocrinology and metabolism clinics of North America, 2022 Nov 04

Remission in Ketosis-Prone Diabetes.

Diabetes research and clinical practice, 2021 Mar 08

GLP-1 receptor agonists and SGLT2 inhibitors for older people with type 2 diabetes: A systematic review and meta-analysis.

Journal of diabetes, 2025 Jun

Monitoring Sarcopenia With Incretin Receptor Activator Treatment.

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 2024 Oct 29

Multisociety clinical practice guidance for the safe use of glucagon-like peptide-1 receptor agonists in the perioperative period.

General Internal Medicine

Diabetes

Questions discussed in this category

Papers discussed in this category

Related Topics in General Internal Medicine