Dr. Mobeen presents a clinician's approach to manage a type II diabetic patient. Following topics are discussed:

• Lifestyle management:
  • Couseling
  • Diet
  • Exercise (150 mins per week.)
• American diabetic academy (ADA) 2016 guidelines.
• Metformin as the first line drug.
• Discussion of mono, dual, tripple, and combination therapy with insulin.
• Why combine metrormin with meals?
• Metformin's half life.
• Metformin's dose.
• Metformin's function:
  • Hepatocyte effects.
  • Reduced gluconeogenesis.
  • Reduced lipogenesis.
  • Block lactic acid uptake.
• A visual mnemonic to remember metformin and glitazones.
• Considerations for patients that may have heart failure, renal failure, or perform rigorous exercises while taking metformin.
• Why metformin is not indicated in type I diabetes mellitus?
• B12 absorption reduction due to Ca++ channel blockade by metformin.