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T2DM: glycaemic management
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[accordion_item title=”Agree and set a target HbA1c value with the patient“]
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Agree and set a target HbA1c value with the patient |
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Lifestyle or single drug that is not associated with hypoglycaemia 48 mmol/mol (6.5%) Or *agreed target |
A drug that is associated with hypoglycaemia or 2 or more drugs 53 mmol/mol (7.0%) Or *agreed target |
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*Patient and disease factors to determine optimal HbA1c targets |
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[accordion_item title=”Offer lifestyle advice at each visit and monitor HbA1c“]
Offer lifestyle advice at each visit and monitor HbA1c
- Offer structured education (DESMOND) to patients and/or their family members or carers at and around the time of diagnosis, with annual reinforcement and review.
- Encourage smoking cessation if the person smokes.
- Dietary history should be obtained and advice should be provided.
- Encourage weight loss if the person is overweight
- Encourage regular exercise (refer for local schemes if appropriate).
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[accordion_item title=”If the person is symptomatically hyperglycaemic, consider insulin or a SU. Review treatment when blood glucose control has been achieved.“]
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[accordion_item title=”New diagnosis of Type 2 Diabetes“]
Give dietary advice on healthy eating and lifestyle changes and agree a HbA1c target (see above for details).
1. Consider 3 months of lifestyle changes and repeat HbA1c before starting medication.
2. Alternatively start oral medication especially if FPG > 15mmol/l or HbA1c > 69mmol/mol (8.5%).
If starting medication first line treatment should be [ez_popup type=”content” text=”METFORMIN” thumb_url=”Thumbnail image URL here…” width=”450″ height=”600″][do_widget id=text-37][/ez_popup] alternatively if BMI < 25, a rapid therapeutic response is required, or metformin is contra-indicated prescribe [ez_popup type=”content” text=”GLICLAZIDE” thumb_url=”Thumbnail image URL here…” width=”450″ height=”600″][do_widget id=text-38][/ez_popup]
Repeat HbA1c in 3 months.
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[accordion_item title=”Management in adults who can take Metformin” open=”true”]
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[accordion_item title=”Management when Metformin is contraindicated or not tolerated“]
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[accordion_item title=”Management using Insulin based treatment“]
Coming Soon!
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