ehmet Yavuz is 62 yo. He presented to the clinic and after having an HbA1c test (result 9%) was diagnosed with type 2 Diabetes mellitus. His cardiovascular risk was > 15%  http://www.cvdcheck.org.au/ His renal health screen showed an eGFR 90 mL/min/1.73m2 with microalbuminuria of 3.5 mg/mmol.   http://www.kidney.org.au/HealthProfessionals/DetectingCKD/tabid/632/Default.aspx He attended a podiatry appointment which detected decreased dorsalis pedis and posterior tibialis pulses in both legs.  Management of his condition now includes the following: Exercise: at least 150 minutes of aerobic and 60 minutes of resistance exercise each week Diet: a plan worked out with an accredited dietician based on the Australian Dietary Guidelines (2013). Drug use: smoking cessation plan to stop cigarette use; alcohol consumption reduction to 1 - 2 full strength beers every second day Weight loss: Mehmet aims to lose 5 kg over the first 6 - 8 weeks after diagnosis Medications: Jardiamet (empagliflozin 5mg, metformin 500 mg), twice daily, with or after food ramipril 5 mg, daily Rosuzet (rosuvastatin 20mg, ezetimibe 10mg), daily Ongoing diagnostics: HbA1c: every 3 months

Mehmet Yavuz is 62 yo. He presented to the clinic and after having an HbA1c test (result 9%) was diagnosed with type 2 Diabetes mellitus.

His cardiovascular risk was > 15%  http://www.cvdcheck.org.au/

His renal health screen showed an eGFR 90 mL/min/1.73m² with microalbuminuria of 3.5 mg/mmol.  

http://www.kidney.org.au/HealthProfessionals/DetectingCKD/tabid/632/Default.aspx

He attended a podiatry appointment which detected decreased dorsalis pedis and posterior tibialis pulses in both legs.

 Management of his condition now includes the following:

1. Exercise: at least 150 minutes of aerobic and 60 minutes of resistance exercise each week
2. Diet: a plan worked out with an accredited dietician based on the Australian Dietary Guidelines (2013).
3. Drug use: smoking cessation plan to stop cigarette use; alcohol consumption reduction to 1 - 2 full strength beers every second day
4. Weight loss: Mehmet aims to lose 5 kg over the first 6 - 8 weeks after diagnosis

Medications:

1. Jardiamet (empagliflozin 5mg, metformin 500 mg), twice daily, with or after food
2. ramipril 5 mg, daily
3. Rosuzet (rosuvastatin 20mg, ezetimibe 10mg), daily

Ongoing diagnostics:

1. HbA1c: every 3 months
2. lipid profile: every 3 months
3. renal function assessment: annually
4. podiatrist assessment: at least once a year
5. optometrist assessment: at least once a year

question:

relate metformin therapy to Mehmet's pathophysiological presentation in brief.