Master Diabetic Pharmacology Through Interactive Simulation
GlucoSense is built on the latest ADA 2026 guidelines and CCS 2022 recommendations. Examine virtual patients, consult through realistic dialogues, and practice selecting the right glucose-lowering medication for every clinical scenario.
20+
Patient Cases
8
Drug Classes Covered
10
Body Regions
4
Guideline Sources
Evidence Foundation
Built on the Latest Clinical Guidelines
Every patient case and drug recommendation in GlucoSense is grounded in peer-reviewed evidence from four authoritative sources.
ADA Standards of Care 2026
Diabetes Care 2026;49(Suppl. 1):S183-S215
- Person-centered shared decision-making guides medication choice for T2D (Rec 9.5)
- GLP-1 RA and/or SGLT2i with proven CV benefit for patients with established or high-risk ASCVD (Rec 9.7)
- SGLT2i recommended for T2D with heart failure, regardless of ejection fraction (Rec 9.8)
- SGLT2i or GLP-1 RA with CKD benefit for eGFR 20-60 or albuminuria (Rec 9.10)
- GLP-1-based therapy preferred over insulin initiation for most adults with T2D (Rec 9.21)
ADA/EASD Consensus Report 2022
Davies et al. Diabetes Care 2022;45(11):2753-2786
- Weight reduction of 10-15%+ can have disease-modifying effect and lead to diabetes remission
- Holistic approach: glycemic management + weight + CV risk factors + comorbidities
- SGLT2i and GLP-1 RA benefits largely independent of their glucose-lowering effects
- Combination therapy considered at initial treatment to shorten time to glycemic goals
- DSMES is as important to the treatment plan as selection of pharmacotherapy
CCS Guideline for Cardiorenal Risk 2022
Mancini et al. Can J Cardiol 2022;38:1153-1167
- SGLT2i reduces CV death by 16% and hospitalization for HF by 31% in HFrEF (DAPA-HF/EMPEROR-Reduced)
- SGLT2i recommended for HFpEF: 29% reduction in HF hospitalization (LVEF >40%)
- GLP-1 RA reduces MACE by 14%, nonfatal stroke by 16% in T2D with ASCVD
- Routine screening with eGFR, UACR, A1c, and LVEF for comprehensive CV risk assessment
- SGLT2i reduces composite kidney outcomes by 36% in patients with CKD
ADA Hospital Care Standards 2026
Diabetes Care 2026;49(Suppl. 1):S339-S355
- Initiate insulin for persistent hyperglycemia >= 180 mg/dL confirmed on two occasions (Rec 16.4)
- ICU glycemic goal: 140-180 mg/dL; non-ICU goal: 100-180 mg/dL (Rec 16.5)
- A1C test on admission if no result available from prior 3 months (Rec 16.1)
- CGM continued during hospitalization with confirmatory POC for insulin dosing (Rec 16.6)
- Specialized diabetes teams reduce length of stay and improve glycemic outcomes
Pharmacology Reference
8 Drug Classes You Need to Master
Data sourced from ADA 2026 Table 9.2 and the ADA/EASD Consensus. Each class has distinct efficacy, safety, and organ-protective profiles.
| Drug Class | Glucose Efficacy | Weight Effect | Hypo Risk | CV / Kidney Notes |
|---|---|---|---|---|
| Metformin | High | Neutral | No | Potential benefit. Contraindicated eGFR <30 |
| SGLT2 Inhibitors | Intermediate-High | Loss | No | MACE reduction (canagliflozin, empagliflozin). Start with eGFR >= 20; glucose benefit reduced <45 |
| GLP-1 Receptor Agonists | High-Very High | Loss (high) | No | MACE, stroke, CV death reduction. Preferred in advanced CKD (eGFR <30) |
| Dual GIP/GLP-1 RA | Very High | Loss (very high) | No | HFpEF symptom reduction with obesity. Emerging data on CKD benefits |
| DPP-4 Inhibitors | Intermediate | Neutral | No | Neutral. Dose adjust per agent; some usable at all eGFR |
| Insulin | Very High | Gain | Yes | Neutral. Dose reduction often needed in CKD |
| Sulfonylureas | High | Gain | Yes | Neutral. Increased hypo risk in CKD; avoid glyburide |
| Thiazolidinediones | High | Gain | No | Pioglitazone: potential benefit. Fluid retention; avoid in NYHA III-IV HF |
Adapted from ADA Standards of Care 2026, Table 9.2 & ADA/EASD Consensus Report 2022
Decision Pathways
Guideline-Based Treatment Algorithm
The ADA 2026 Figure 9.4 algorithm prioritizes cardiorenal protection on the left and weight/glycemic goals on the right. Here are the key decision pathways you will practice in GlucoSense.
Established ASCVD or High CV Risk
GLP-1 RA with proven CV benefit and/or SGLT2i with proven CV benefit, irrespective of A1C
GLP-1 RA: 14% MACE reduction, 13% stroke reduction. SGLT2i: 12% MACE reduction, 32% HF hospitalization reduction.
ADA Rec 9.7, CCS Table 1
Heart Failure (HFrEF or HFpEF)
SGLT2i with proven HF benefit for glycemic management and HF hospitalization prevention
HFrEF: 31% reduction in HF hospitalization, 16% CV death reduction. HFpEF: 29% HF hospitalization reduction (DELIVER, EMPEROR-Preserved).
ADA Rec 9.8, CCS PICO 1-2
CKD (eGFR 20-60 or Albuminuria)
SGLT2i and/or GLP-1 RA with demonstrated CKD benefit on max tolerated ACEi/ARB
SGLT2i: 36% composite kidney outcome reduction. In advanced CKD (eGFR <30), GLP-1 RA preferred for glycemic management.
ADA Rec 9.10-9.11, CCS PICO 3
Obesity & Weight Management
GLP-1 RA or dual GIP/GLP-1 RA with highest weight efficacy; consider metabolic surgery if BMI criteria met
Tirzepatide and semaglutide provide very high weight loss (10-15%+). 5-10% loss improves metabolic parameters; 10-15%+ can lead to remission.
ADA Rec 9.19, ADA/EASD Consensus
MASLD / MASH
GLP-1 RA preferred for glycemic management; pioglitazone or dual GIP/GLP-1 RA for MASH benefit
GLP-1 RA and pioglitazone show benefits in biopsy-proven MASH. Combination pioglitazone + GLP-1 RA can be considered.
ADA Rec 9.12-9.13
Inpatient / Hospital Setting
Insulin therapy for persistent hyperglycemia >= 180 mg/dL; glycemic goal 140-180 mg/dL in ICU, 100-180 mg/dL non-ICU
NICE-SUGAR trial: moderate targets (140-180 mg/dL) safer than tight control (80-110 mg/dL) with lower mortality and hypoglycemia.
ADA Rec 16.4-16.5
Platform Features
Learn by Doing, Not Just Reading
GlucoSense combines visual learning with clinical reasoning for deeper pharmacological understanding.
Interactive Body Avatar
Click on 10 body regions to examine your patient. Visual indicators display disease severity and real-time drug effects.
Patient Consultation
Ask up to 10 questions per body region. Patients respond with realistic symptoms based on their clinical profile.
Drug Selection Training
Choose from 8 diabetes drug classes including Metformin, SGLT2i, GLP-1 RA, dual GIP/GLP-1 RA, DPP-4i, insulin, SU, and TZDs.
Evidence-Based Scoring
Each case is scored against ADA 2026 and CCS 2022 guideline recommendations, with detailed rationale.
Diverse Case Library
20+ patients spanning different ages, genders, BMIs, and comorbidity profiles (ASCVD, HF, CKD, MASLD/MASH, obesity).
Instant Feedback
See how your treatment choice impacts the patient avatar with visual feedback and evidence-based explanations.
Practice Cases
Real-World Clinical Complexity
Each patient presents unique comorbidities that map directly to guideline decision pathways.
Robert Chen
58 years old
Uncontrolled T2DM with prior MI and peripheral artery disease
ADA Rec 9.7: GLP-1 RA and/or SGLT2i with proven CV benefit
Maria Vasquez
45 years old
Newly diagnosed T2DM with BMI 42, biopsy-proven MASH
ADA Rec 9.12: GLP-1 RA preferred; consider dual GIP/GLP-1 RA
James Wright
72 years old
T2DM with HFrEF (LVEF 35%) and progressive CKD (eGFR 28)
ADA Rec 9.8 + 9.11: SGLT2i for HF; GLP-1 RA preferred for glycemic control in advanced CKD
~50%
Microvascular complication reduction with intensive therapy (DCCT)
14%
MACE reduction with GLP-1 RA in T2D + ASCVD
31%
HF hospitalization reduction with SGLT2i in HFrEF
36%
Composite kidney outcome reduction with SGLT2i in CKD