T2DM Flashcards
T2DM HbA1c target range
48: Lifestyle modifications only, on monotherapy without hypoglycaemic effect
53: On a hypoglycaemic agent
HbA1c monitoring
After initiation: 3-6/12, and then every 6/12
When to intensify T2DM Tx
HbA1c 58:
1st: Reinforce lifestyle changes
2nd: ?Adherance to drugs
3rd: Support patient to target Hba1c at 53
4th: Add drug Tx, if appropriate
For T2DM patitent who has cardiovascular disease or high risk
Offer Metformin + SGLT-2 as 1st line
How to initiate people w/ dual therapy of metformin + SGLT-2 inhibitors?
Initiate Metformin 1st and ensure tolerability and then initiate SGLT-2
According to CKS, what drugs can Dapa only be taken with
Metformin + Sulfonylureae ONLY
When to consider GLP-1?
- Triple therapy w/ BMI >35
- Insulin therapy would be an sig. occupational implication OR
- WL would benefit other obesity-related comorbidities
Hypoglycaemic glucose level
< 3.5mmol/L
When to consider insulin therapy for patient?
- On maximum drug therapy
- If unable to tolerate anti-DM drugs
BP target for Pt < 80 w/ T2DM
< 140/90
BP Target for Pt > 80 w/ T2DM
< 150/90
Autonomic complications of DM
- Gastroparesis: Delayed gastric emptying by Vagus nerve dysfunction
T2DM glucose Diagnostic range
Define T2DM
T2DM is a condition where a combination of insulin resistance and reduced insulin production cause persistently high serum blood sugar levels.
Insulin function
To move glucose from serum to cells by binding onm the insulin receptors on cells
Glucogon function
To increase serum glucose by breaking down glycogen in the liver
where is glucogon released
alpha cells - Islet of Langerhans
where is insulin released
Beta cells - Islet of Langerhans
