Management of Diabetes

Aspects of management

There are 4 key aspects to consider in the management of diabetes

  1. Monitoring disease progression
  2. Conservative management
  3. Medical management
    1. Oral antidiabetic medications – used in T2DM 
    2. Insulin Therapy – used in T1DM and T2DM
Treatment Aims

There are 3 main treatment aims

  • Manage glucose control: There are 2 aspects to this:
    1. Maintain Hba1c ≤ 7.5% or ≤6.5%
      • The strictness of the limits depends on the patient – essentially, more ill patients get more leeway
      • Relieve hyperglycaemic symptoms
    2. Treat risk factors – e.g. metabolic syndrome
  • Manage + prevent complications  (see separate)
    • Good metabolic control is the main aspect of preventing complications
      • Currently aggressively control for this reason
    • Cardiovascular risk (macrovascular disease) is the most important complication to manage
      • Microvascular disease is also managed – see separate
  • Prevent iatrogenic problems 
    • E.g. hypoglycaemia
  1. Management of Type 1 vs Type 2 Diabetes

Both types of diabetes involve strict monitoring and conservative management. However, the key difference is in medical management, with oral antidiabetic medications only having a role in T2DM (whereas insulin is used in both)

 

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