Steve V. Edelman, MD
Robert R. Henry, MD
The primary treatment goals of managing Type 2 diabetes are to:
• Eliminate symptoms of hyperglycemia
• Recognize the symptoms of hypoglycemia….
diabetes made simple occur (🔥 diagnostic procedures) | diabetes made simple uncontrolledhow to diabetes made simple for • Achieve and maintain normal or near-normal metabolic and biochemical parameters (both fasting and postprandial blood glucose levels, A1C [Table 12.1], LDL and HDL cholesterol, and fasting triglycerides)
• Achieve normal blood pressure and address procoagulant state
• Reduce insulin resistance and its adverse metabolic consequences
• Assist the patient in achieving and maintaining a reasonable body weight
diabetes made simple herpes (☑ nails) | diabetes made simple glucose rangehow to diabetes made simple for • Prevent or delay the development and progression of microvascular and macrovascular complications
Therapeutic efforts to achieve these goals involve using a variety of treatment modalities:
• Dietary modifications
• Regular physical activity
• Aspirin therapy
• Antidiabetic the 1 last update 12 Jul 2020 agents• Antidiabetic agents
• Insulin injections.
An individualized approach is the 1 last update 12 Jul 2020 recommended based on:An individualized approach is recommended based on:
• Patient age
• The presence of coexisting illnesses and/or diabetes-related complications
• Lifestyle, including:
• Financial for 1 last update 12 Jul 2020 considerations• Financial considerations
• Ability to learn and follow self-management skills
• Level of patient motivation.
The cornerstone of effective diabetes management is maintaining good glycemic control. Compelling evidence indicates that long-term glycemic control can prevent or delay the microvascular complications of diabetes.
The DCCT and the UKPDS demonstrated definitively the value of improved glycemic therapy in patients with Type 1 and Type 2 diabetes in delaying the onset and slowing the progression of retinopathy, nephropathy, and neuropathy.
The benefits of reducing glycemia are seen in both Type 1 and Type 2 diabetes. The ADA now recommends establishing a management goal of achieving the best possible blood glucose control in patients with Type 2 diabetes. Treatment methods for managing Type 2 diabetes should focus on:
diabetes made simple pathophys (🔥 breakfast) | diabetes made simple symptomshow to diabetes made simple for • Dietary modifications
• Weight control
• Supplemental oral hypoglycemic agents and/or insulin as needed.
The following algorithm (Figure 12.1) provides a general guideline for making decisions regarding the various types of pharmacologic therapy. It should be noted that several consensus algorithms proposed by various organizations such as the ADA, the EASD, the AACE, and the Texas Diabetes Council differ somewhat in their details including glycemic targets and the sequential use of specific medications. For example, the target glycemic goal proposed by the AACE is an A1C of 6.5% whereas a goal of A1C
Next Week, Assessment of the Treatment Regimen
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diabetes made simple e119 (🔥 blood test) | diabetes made simple hyperglycemiahow to diabetes made simple for American Diabetes Association. Standards of medical care in diabetes–2010. Diabetes Care. 2010;33(suppl 1):S11-S61.
American Diabetes Association. Medical Management of Non–insulindependent (Type II) Diabetes. 3rd ed. Alexandria, VA: American Diabetes Association; 1994:22-39.
diabetes made simple neuropathy treatment (🔴 glucose range) | diabetes made simple statistics australiahow to diabetes made simple for Davidson JA, Blonde L, Jellinger PS, et al. Road map for the prevention and treatment of type 2 diabetes. http://www.aace.com/meetings/consensus/odimplementation/roadmap.pdf. Accessed July 2, 2010.
diabetes made simple weight gain (⭐️ urination) | diabetes made simple by racehow to diabetes made simple for Mudaliar S, Henry RR. Combination therapy for type 2 diabetes. Endocrinol Pract. 1999;5:208-219.
Nathan DM, Buse JB, Davidson MB, et al. Management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia. 2006;49:1711-1721.
Ohkubo Y, Kishikawa H, Araki E, et al. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non–insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Res Clin Pract. 1995;28:103-117.
United Kingdom Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837-853.
Texas Diabetes Council. Insulin Algorithm for Type 2 Diabetes Mellitus in Children and Adults. October 20, 2005. http://www.tdctoolkit.org/algorithms_and_guidelines.asp. Accessed July 2, 2010.
the 1 last update 12 Jul 2020
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