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Managemnt
Diet
Life style changes
Oral drugs
Insulins
Incretin based therapies
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First line of therapy
Medical nutrition therapy Exercise Weight loss
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Total calories
Carbohydrates 50%
Fat 30%
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Which drug is the preferred initial therapy in type 2 DM?
Metformin If blood sugar is not controlled
Metformin + insulin secretogogues If blood sugar is still not controlled
Reassess Hb A 1c Finally, insulin with or without combination
oral drugs
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Oral glucose-lowering agents
If the target blood sugar level is not achieved after 4 weeks
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Insulin
Most doctors Only if blood sugar control cannot be obtained
with oral hypoglycemic drugs
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Exercise
Lowers plasma glucose during and following exercise
Increase insulin sensitivity in both type 1 and type 2 DM
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Exercise has multiple benefits
Cardiovascular benefits Reduced BP Maintenance of muscle mass Reduction in body fat Weight loss
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Normal HbA1c
< 6%
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HbA1c% with treatment
< 7. 0
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Plasma glucose
10 – 15 % > whole blood
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