WEBVTT

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Elena's A one C is at goal.

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She also has type two diabetes
and a previous heart attack.

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Those facts raise a separate
treatment question:

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which options have demonstrated
cardiovascular benefit

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for someone like her?

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Start with the disease and the outcome,

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then read the trial population,
comparator, benefit, and harms.

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Greater weight loss does not, by itself,

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prove greater protection
from cardiovascular events.

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A study that establishes noninferiority

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has not necessarily shown superiority.

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At follow-up, Elena is losing weight,

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but she has nausea, small
meals, and less energy.

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She can drink and has no severe
pain or persistent vomiting.

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Before the next dose increase,

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the prescriber and registered
dietitian should review symptoms,

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food and fluids, recent dose
changes, and daily function.

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Nutrition and suitable resistance activity

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need to fit her health,
abilities, and resources.

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Persistent vomiting,
inability to maintain fluids,

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or severe persistent abdominal pain

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needs prompt clinical assessment.

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At the next visit, review the
intended treatment benefit

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and what Elena can actually do.

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Agree who will follow up, when,

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and what happens if that visit is missed.