[Marlena Morrison]

The main barriers I have faced in my practice for individualizing antihyperglycemic agents include drug coverage/cost, increased frailty, and complex comorbidities ie liver cirrhosis, ESRD, and cogntive impairment. In Ontario, where I am located, for those who do have private coverage or coverage under the Ontario Drug Benefit, I find the biggest barrier to individualizing antihyperglycemic agents is recultance to add an additional medication (ie polypharmacy) and concerns regarding potential associated side effects with some antihyperglycemic agents. I find exploring these concerns and using reflective listening to be a good approach, as well as providing the necessary education an individual needs to make an informed decision without casting judgement.