Combination Therapy and Clinical Use
Start with the big picture
Combination therapy generally adds a medicine with a complementary action to metformin when HbA1c remains above target after a period of treatment; some patients may begin with dual therapy, while more marked hyperglycemia or catabolic features may prompt consideration of insulin. Selection depends on clinical priorities: SGLT2 inhibitors may be favored with heart failure or kidney disease, while GLP-1 receptor agonists may suit patients seeking weight reduction or with predominant atherosclerotic cardiovascular disease. The topic also compares insulin-based combinations and fixed-dose products, and highlights pairings that can increase hypoglycemia risk or offer little added benefit. Renal impairment, pregnancy, and older age or high hypoglycemia risk affect medication choices and precautions.
What you'll learn
- Recognize circumstances that may prompt dual therapy, triple therapy, or basal insulin.
- Select add-on drug classes in light of comorbidities, weight goals, and hypoglycemia risk.
- Identify combinations that warrant caution or are not recommended.
- Describe how renal function, pregnancy, and older age can influence therapy choices.
Continue your study
Work through the complete notes and reinforce the topic with the study tools available in the full lesson.
