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Metformin still is the king!

                      American College of Physicians (ACP) recommendations.
what outcomes one has to evaluate before prescribimg medication?
Hemoglobin A1c, weight, systolic blood pressure, and heart rate; all-cause mortality, cardiovascular and cerebrovascular morbidity and mortality; retinopathy, nephropathy, neuropathy; “Metformin, unless contraindicated, is an effective treatment strategy because it has better effectiveness, is associated with fewer adverse effects, and is cheaper than most other oral medications,”
If a second oral medication is needed to improve high blood sugar, ACP recommends that physicians consider adding either a sulfonylurea, thiazolidinedione, SGLT-2 inhibitor, or DPP-4 inhibitor to metformin.


Before i conclude, let me reveal another variant called as  LADA, Latent Autoimmune Diabetes of Adulthood , Type 1.5,which is in  Epidemic proportion in India!

LADA is a form of type 1 diabetes that develops later into adulthood. 
LADA is an autoimmune disease in which the body’s immune system attacks and kills 
off insulin producing cells.
In India more than 30%  people,who have been diagnosed with type 2 diabetes, in reality  have LADA.
The only way to diagnose LADA is with a blood test for islet-cell antibodies.
A Glutamic Acid Decarboxylase Autoantibodies test (GAD antibodies test) is used to help discover whether someone has either type 1 diabetes or Latent Autoimmune Diabetes of Adulthood (LADA).  

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