Treatment principles T2DM

Question 1

Treatment (5)

Answer 1

1 diagnosis
2 therapeutic lifestyle changes
3 monotherapy
4 combination therapy- no insulin
5 combination therapy- with insulin

Question 2

Therapeutic Lifestyle changes (7)

Answer 2

Exercise

Diet
- Aim for realistic targets with weight maintenance/ modest weight loss- i.e. 5-10 kg in one year

• General guidance on healthy eating:
  -Normal intake of unrefined carbohydrate foods,
  -Reducing refined sugar, salt + fat intake
  -Increasing (fruit) and vegetable intake
  -Safe and sensible alcohol consumption

Question 3

Prevent microvascular complications (2)

Answer 3

-glucose control (glycated haemoglobin, HbA1c)
–aim for HbA1c < 7.0% (53mmol/mol)

Question 4

Prevent cardiovascular complications (3)

Answer 4

-cholesterol control
–blood pressure control
–antiplatelet therapy

Question 5

HbA1c target for T2DM

Answer 5

• 7% (53mmol/mol)

Question 6

HbA1c target at T2DM diagnosis

Answer 6

• 6.5% (48 mmol/mol)

Question 7

HbA1c target for patient on triple oral therapy or insulin

Answer 7

58 mmol/mol

Question 8

an elderly patient with dementia

Answer 8

to minimize symptoms of hyperglycaemia

Long term risk reduction for microvascular disease is not a priority.