विवरण
The main aim of diabetes treatment is to return blood sugar to a safe threshold and reduce the risk of complications while helping a person with diabetes to resume daily function by maintaining glucose levels as close to normal as safely possible.
Join us on the coming up webinar with Dr Gautam as this case based discussion on Medical management program enables you to make more consistent and appropriate adjustments in the diabetic patients therapy and lifestyle.
सारांश
- Diabetes management is multifaceted, involving patient education, setting realistic goals, and addressing both immediate symptoms and long-term complications. It's crucial to inform patients about the chronic nature of diabetes and the importance of diet, exercise, and medication adherence. Regular follow-up is necessary to monitor progress and adjust treatment plans.
- Initial therapy typically involves lifestyle modifications and metformin, a safe medication with rare but potential side effects like lactic acidosis. Regular monitoring of blood pressure, eye exams for retinopathy, foot exams, lipid profiles, and urine tests for microalbuminuria are essential components of comprehensive care. Patient education should encompass self-monitoring of blood glucose, understanding hypoglycemia symptoms, and proper foot care.
- When metformin alone is insufficient, a second agent is added, with options including sulfonylureas, thiazolidinediones, gliptins, and SGLT2 inhibitors. Sulfonylureas are potent but carry risks of hypoglycemia and weight gain. Thiazolidinediones are less commonly used due to weight gain and edema. Gliptins have fewer side effects but may be less effective.
- SGLT2 inhibitors offer benefits such as weight loss and cardiovascular protection but increase the risk of genital and urinary infections. GLP-1 agonists are injectables with cardiac and renal benefits, along with weight loss. When multiple agents are ineffective, insulin therapy becomes necessary.
- Insulin regimens can range from basal insulin to basal-bolus therapy, mimicking physiological insulin secretion. Premix insulin provides convenience but requires fixed meal timings. Newer insulins offer faster action. Continuous glucose monitoring (CGM) with insulin pumps represents the future of diabetes management.
- In hospitalized patients, oral medications are often discontinued in favor of short-acting insulin before meals and basal insulin. Continuous insulin infusion is appropriate for unstable patients in the ICU. When stopping insulin infusion, overlap with subcutaneous insulin to prevent rebound hyperglycemia.
- Patient communication and adherence are key. Tailoring treatment to the individual's needs and circumstances, considering costs and potential side effects, is paramount. Newer medications should be used judiciously in conjunction with established protocols.
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जनरल मेडिसिन में एम.डी., उस्मानिया मेडिकल कॉलेज एमआरसीपी, यूके इंटरनल मेडिसिन में एम.डी., यूएसए अमेरिकन बोर्ड सर्टिफाइड इंटरनल मेडिसिन
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