A 52-year-old woman with type 2 diabetes mellitus presents with a fasting blood glucose of 187 mg/dL, BP 128/82 mmHg, HR 78/min, and BMI 31 kg/m². Her recent HbA1c is 8.2% despite metformin 1000 mg twice daily for six months. Creatinine is 0.9 mg/dL with an eGFR of 78 mL/min/1.73m². She refuses injectable medications and expresses concern about further weight gain. Physical exam reveals mild truncal obesity without lower extremity edema. She denies polyuria or polydipsia. Which incretin-based medication best addresses her treatment goals while minimizing weight gain?
- A)NPH insulin
- B)Pioglitazone
- C)Glyburide
- D)SitagliptinGABARITO
- E)Semaglutide
Explicação
Sitagliptin is an oral DPP 4 inhibitor that increases endogenous incretin activity and is generally weight neutral. In contrast, semaglutide is a GLP 1 receptor agonist that often promotes greater weight loss but is commonly delivered by injection. Ver explicação completa e trilha adaptativa →