Diabetes Medications

An overview of the classes, mechanisms, indications, and side effects of diabetes medications, including metformin, SGLT2 inhibitors, GLP-1 receptor antagonists, DPP4 inhibitors, and sulfonylureas. Pdf of slides available for download here: https://drive.google.com/drive/folders/0B9SDUwepGWeUTmtscnJSSjR5OE0

Summary of 2017 ADA Guidelines: https://emedicine.medscape.com/article/117853-guidelines

Complete 2018 ADA Guidelines: https://diabetesed.net/wp-content/uploads/2017/12/2018-ADA-Standards-of-Care.pdf

Summary of AACE Guidelines: https://www.aace.com/disease-state-resources/diabetes/depth-information/glycemic-management-type-2-diabetes

Strong Medicine video on the Normal Physiology of Insulin and Glucagon: https://www.youtube.com/watch?v=-3J6QRMerQE

#diabetes #diabetic #hyperglycemia

39 Comments

  1. True-Hype-Media on May 3, 2021 at 12:17 am

    Loved it sir!!

  2. Nazra Nuhman on May 3, 2021 at 12:18 am

    Absolutely wonderful! Thank you

  3. Strong Medicine on May 3, 2021 at 12:19 am

    In the video, I mention that the algorithm presented is "generally" consistent with ADA and AACE guidelines. In short, the video algorithm recommends that lifestyle modifications can be initially tried alone for motivated patients whose A1c<7.5%; while ADA/AACE guidelines recommend anyone diagnosed with type 2 diabetes, no matter how near-normal their A1c is, should be placed on metformin. In other words, the implication is that there should be no such thing as "diet controlled diabetes". Other recommendations may use A1c cutoffs of 7.0%. Given that motivated individuals with newly diagnosed type 2 diabetes can bring down their A1c 1.0-2.0% with lifestyle modifications alone, and because I personally trend my practice towards keeping patient pill burden on the lower end, I don’t personally recommend starting metformin at A1c levels < 7.5% *IF* the patient is motivated and otherwise able to enact major dietary changes. The argument against this (i.e. the argument to start every patient with type 2 diabetes on metformin) is that it’s cheap and very safe, and that attempts to use lifestyle modifications alone is not successful for most patients. But I’m not convinced there is any benefit (EDIT: patient-centered benefit) to using metformin for those patients whose A1c could otherwise be successfully brought to their target A1c with diet/weight loss alone.

  4. Ann Alcantara on May 3, 2021 at 12:20 am

    My high blood ano ang gmot .

  5. Moatasem Hanadi on May 3, 2021 at 12:21 am

    "2:40" This is glorious, You ever tried – Nanadelyn Nenogan Magic ?
    Go to 𝘀𝘁𝗼𝗽𝗱𝗶𝗮𝗯𝗲𝘁𝗲𝘀𝟮𝟰𝟳 .𝗰𝗼𝗺 (remove spaces)
    It is a great exclusive product for discovering how to get rid of type two diabetes minus the normal expense. Ive heard some interesting things about it and my work buddy got cool success with it.

  6. MedNerd - Dr. Waqas Fazal on May 3, 2021 at 12:21 am

    Amazing video, amazing content ❤️

  7. Ann Alcantara on May 3, 2021 at 12:23 am

    4years na ako take ng metformin

  8. Kgreasy on May 3, 2021 at 12:24 am

    Thank you Dr. Strong for another great video. Metformin still looks like the number one drug to prescribe. Do you have any recommendations on how to overcome the B12 absorption problem?

  9. Alex mirhos on May 3, 2021 at 12:26 am

    Thank you for an excellent summary , I wonder about HBA1c goal , is it 7.5 as in the shown image or 7%, 53 mmol/mmol, as in most international guidelines?

  10. Wittawat Kasayapanand on May 3, 2021 at 12:26 am

    Thank you very much Doctor Eric Strong, this is my third time, watching this video, and I seem to grasp thing I didn’t before. I did not watch medical video to take any particular examination, but I found ,that yours are the BEST in practical medicine, which I would never get if only I just read from textbook, or manual. I thank you for taking time to teach us , Doctors around the world. I would like to wish you and your family a very very Merry Christmas and a Happy New Year ! I have been listening your lectures for a little over the year , how time fly. 🙂

  11. Sunny on May 3, 2021 at 12:29 am

    Absolutely great video!

  12. abdullah saleh on May 3, 2021 at 12:30 am

    Dr Stronng ; Thaaaanks for you from Saui Arabia 🤚🏻 I am following your channel with great intrest … I cnseder you my best teacher 👌🌺🌹

  13. venkybly on May 3, 2021 at 12:30 am

    Tq

  14. Bob Bradley on May 3, 2021 at 12:35 am

    It should be noted that SGLT2 are not allowed for pilots going for a new Medical license. Example Invokana is one.

  15. Abdulaziz on May 3, 2021 at 12:36 am

    Thank you very much for these great videos, really appreciated!

  16. Lalrinchhana Ralte on May 3, 2021 at 12:38 am

    Thank youn once again dr. Eric

  17. malek khan on May 3, 2021 at 12:38 am

    Acca dayabetic metro pro name Kono osud ace ki

  18. Daily Dose of Medicine on May 3, 2021 at 12:38 am

    Diabetes medications and insulin therapy
    :
    Metformin (Glucophage, Glumetza, others). Generally, metformin is the first medication prescribed for type 2 diabetes.
    Sulfonylureas.
    Meglitinides.
    Thiazolidinediones.
    DPP-4 inhibitors.
    GLP-1 receptor agonists.
    SGLT2 inhibitors.
    Insulin.

  19. Cornel Bacauanu on May 3, 2021 at 12:40 am

    Essential information for anyone taking care of DMT2 patients. Thank you.

  20. Allie Bart on May 3, 2021 at 12:43 am

    Nice video. I am using FreeStyle Libre US14 day with Ambrosia blucon over 2 months now, I am able to calibrate the Libre if readings are more than 10% off. Also, I got alarms and direct connection to Apple watch.

  21. JZoidberg on May 3, 2021 at 12:44 am

    Brilliant summary. Any chance these slides could be released in pdf form? They would be great as a quick study reference.

  22. Muzafar Khan on May 3, 2021 at 12:47 am

    waiting eagerly for Insulins (specially U500 and other new ) Eric

  23. Κωσταντινος Κατζουνος on May 3, 2021 at 12:50 am

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    It is a great one of a kind guide for discovering how to get rid of type two diabetes minus the normal expense. Ive heard some interesting things about it and my buddy got cool success with it.

  24. Tiến Phát Nguyễn on May 3, 2021 at 12:50 am

    0:51 There is a method to reverse your diabetes condition – completely – and you can do it without insulin or glucose-lowering drugs, totally naturally
    👉 𝘀𝘁𝗼𝗽𝗱𝗶𝗮𝗯𝗲𝘁𝗲𝘀𝟮𝟰𝟳 .𝗰𝗼𝗺 (remove spaces)

  25. Άγιος Χίλαριος on May 3, 2021 at 12:53 am

    I came across some studies recommending SGLT2 inhibitors for isolated heart failure with reduced EF.. I want to ask about the risk of hypoglycaemia associated with this group of meds. Another question is about the physiology theoretically it doesn’t make much sense to me that they lower blood glucose (maybe I’m not good enough in renal physiology ) : if Na and glucose were excreted in the proximal tubules wouldn’t this osmotically lead to increased water excretion (acting like a diuretic ) and glucose wouldn’t be much lowered in most cases or even increases (both glc and water are excreted) ? And what would be the effect on renin angiotensin aldosterone system since we are talking about heart failure ?

  26. Hema S on May 3, 2021 at 12:56 am

    Very precise and informative specially when to use which drug and the combination of drugs explained clearly. Thank you so much

  27. Verónica Schmidt on May 3, 2021 at 12:58 am

    Wow! Your videos are amazing. Thank you!

  28. Gisele Montigny on May 3, 2021 at 12:59 am

    great. thanks once more. I am learning with all your videos for a board certification test 🙂

  29. Sachithanandam Karthikselvan on May 3, 2021 at 1:00 am

    Thanks for putting efforts in making these videos.

  30. DIABETES TV PH. 당뇨탈출TV on May 3, 2021 at 1:01 am

    Visit what foods for made high and lower diabetes! May everyone escape from diabetes.

  31. Michael Schachter on May 3, 2021 at 1:05 am

    Great review! In the algorithm you mention GLP1 should be used as add on to metformin in CAD. I was under the impression that these medications have indications for CHF. Is there also CAD data?

  32. jeetu pandey on May 3, 2021 at 1:08 am

    How can I contact you?

  33. Nihal Sheriff on May 3, 2021 at 1:09 am

    Thanks as usual for the great stuff. Looking forward to the video on insulin. Regards.

  34. Owmed on May 3, 2021 at 1:12 am

    Amazing, as always! Im always excited when I see a new lecture posted, since i’ve devoured most of your videos already! Hahaha, if only med teachers were as didatic and interesting as you!

  35. Wittawat Kasayapanand on May 3, 2021 at 1:12 am

    Thank you Dr Strong. This is topic I like you to make , but I know that you are busy, therefore I am grateful that you took time to make. It is wonderful lecture . How severe the liver disease that Glucophage become contraindications?

  36. Andrey Lopukhov on May 3, 2021 at 1:14 am

    Thank you, Dr Strong!
    I am from Australia and enjoying your great videos!
    Keep going.

  37. sid adk on May 3, 2021 at 1:15 am

    Can a pt having hypothyroidism take metformin?

  38. Procyon on May 3, 2021 at 1:17 am

    Thanks for the video, nice explanation.

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