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The American Diabetes Association and European Association for the study of Diabetes consensus guideline recommends that, in people with type 2 diabetes and established atherosclerotic cardiovascular disease, treatment for hyperglycaemia should be diet, lifestyle change and metformin, followed by, if this does not achieve target HbA 1c levels, an agent proven to reduce cardiovascular mortality risk (Davies, 2018)

To determine if this is the most appropriate treatment, pharmacists should consider the following: Administration burden: Include frequency of use and timing with meals

Over time, a much lower food intake can make it harder to get enough of certain nutrients, including B12

doi: 10.1016/j.ijbiomac.2020.05.015 74 MoideenMMJKaruppaiyanKKandhasamyRSeetharamanS