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: 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 lipid profile: every 3 months renal function assessment: annually podiatrist assessment: at least once a year optometrist assessment: at least once a year   QUESTION: From this list choose metformin therapy to discuss. ANSWER THE  the following  QUESTION  IN DETAIL . 1.describe the mechanism of ACTION/S  of metformin 2. identify the AIM of  metformin therapy for Mehmet 3. relate each therapy to Mehmet's pathophysiological presentation in detail.

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:

From this list choose metformin therapy to discuss.

ANSWER THE  the following  QUESTION  IN DETAIL .

1.describe the mechanism of ACTION/S  of metformin

2. identify the AIM of  metformin therapy for Mehmet

3. relate each therapy to Mehmet's pathophysiological presentation in detail.