Total Members

1,23,857

Get Alerts Via :-

Download Android
Download our android application to get medical alerts, drug search, medical dictionary, wikipedia etc.

To downlod our android application simply search for mbbsdost in google play store.
Feed Subscription
Click here to Subscribe to our feed.
Whatsapp alerts
Click here to get medical alerts via Whatsapp.
Facebook Alerts
Click here to get medical alerts via Facebook.
Email Subscribe
Email subscribe here:-

Certificate, Diploma & Fellowship courses. MD, MS,
USMLE and MMSC programs

Amazing software for writing prescription

Medical FunNotes

Interesting medical books

Certificate course in X-ray diagnosis

Certificate course in ECG diagnosis

Please Click Here to login via facebook.

Author of this article:- Devesh Palharya
Old new-questionsNew

Endocrinology and Metabolism


A 67-year-old obese (body mass index, 34) white man has had type 2 diabetes mellitus for the past 8 years. The disease was originally diagnosed on the basis of a routine fasting plasma glucose level of 156 mg/dL and responded well to initiation of a nutrition and exercise plan. The hemoglobin A1C value decreased from 8.8% at diagnosis to 6.9% after 6 months of nutrition therapy and a 5.5-kg (12-Ib) weight loss. After 2 years, the hemoglobin A1C  increased to 8.1%; therapy with glyburide, titrated up to 10 mg/d, was started. The hemoglobin A1C  value then decreased 6.6% and remained less than 7% until 1 year ago. At that time, the patient noted a 7 kg (15-Ib) weight gain and some symptoms of distal paresthesias. The hemoglobin A1C  had increased to 7.7%. The patient is counseled to intensify diet and exercise to lose 7kg (15 Ib).  What is the most appropriate additional intervention at this time?

A. Add repaglinide therapy before breakfast and dinner 

B. Increase the glyburide dosage to 10 mg twice daily  

C. Discontinue glyburide therapy and begin metformin therapy 

D. Add metformin therapy to the current glyburide regimen 

E. Switch from glyburide therapy to glipizide therapy
More details/answers

Supported exams-USMLE step 1, USMLE step 2, USMLE step 3, PLAB, AMC, INDIAN pg, MCI screening ( FMGE ), NEET-PG INCLUDED subjects-