Mark Kennedy1, Adam Roberts. 1. Corio Medical Clinic, Geelong, Victoria. mfgkennedy@coriomedical.com.au
Abstract
BACKGROUND: Patients with type 2 diabetes mellitus frequently have comorbidities that complicate the management of their disease. Many of these patients are prescribed multiple medications to manage hyperglycaemia, hypertension and other comorbidities. Clinicians who manage these patients must deal with the challenge of adjusting multiple medications in the face of renal failure and cardiovascular disease as the disease progresses, as well as tailoring therapy to help patients overcome intolerances and adverse effects. OBJECTIVE: This article explores some of the issues in managing the complex patient, including non-adherence and the challenges associated with achieving glycaemic control in patients with cardiovascular disease and renal impairment. DISCUSSION: Generalists, specifically general practitioners, are well suited to address the complexities of the management of type 2 diabetes mellitus patients. They need to be able to assess the risks and benefits of each treatment decision in light of the patient's glycaemic control, cardiovascular status, renal function and motivation.
BACKGROUND:Patients with type 2 diabetes mellitus frequently have comorbidities that complicate the management of their disease. Many of these patients are prescribed multiple medications to manage hyperglycaemia, hypertension and other comorbidities. Clinicians who manage these patients must deal with the challenge of adjusting multiple medications in the face of renal failure and cardiovascular disease as the disease progresses, as well as tailoring therapy to help patients overcome intolerances and adverse effects. OBJECTIVE: This article explores some of the issues in managing the complex patient, including non-adherence and the challenges associated with achieving glycaemic control in patients with cardiovascular disease and renal impairment. DISCUSSION: Generalists, specifically general practitioners, are well suited to address the complexities of the management of type 2 diabetes mellituspatients. They need to be able to assess the risks and benefits of each treatment decision in light of the patient's glycaemic control, cardiovascular status, renal function and motivation.
Authors: Preya Janubhai Patel; Kelly Lee Hayward; Rathiga Rudra; Leigh Ula Horsfall; Fabrina Hossain; Suzanne Williams; Tracey Johnson; Nigel Neil Brown; Nivene Saad; Andrew Donald Clouston; Katherine Anne Stuart; Patricia Casarolli Valery; Katharine Margaret Irvine; Anthony William Russell; Elizabeth Ellen Powell Journal: Medicine (Baltimore) Date: 2017-06 Impact factor: 1.889