Management of Diabetes

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)