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Starting a Prednisone-Using Patient on Insulin
Preferred Answer: Yes, consider changing his blood glucose medications
John’s glucocorticoid therapy for asthma is raising his blood glucose beyond what the current metformin and glimepiride regimen can control. The metformin is already at its maximum effective dose of 1000 mg, bid.1
| What medication changes would you propose to John? | |
| Add an alpha-glucosidase inhibitor such as acarbose (Precose®) with each meal | |
| Increase glimepiride to 8 mg daily | |
| Add long-acting insulin such as glargine (Lantus®) or detemir (Levemir®) at bedtime | |
| Add a TZD (thiazolidinedione) such as Actos® (pioglitazone) or Avandia® (rosiglitazone) | |
| Add premixed insulin before breakfast | |
1. Glucophage® (metformin hydrochloride tablets) package insert
The material presented here is for informational purposes only and does not imply BD endorsement of specific therapies, treatments, or products discussed in the presentations. Individual clinical judgments should be used in all patient care decisions. © 2010 BD.