Sugar control
STOP
Treatment
Non-Pharmacology Pharmacology
• Diet • OHA
• Weight Mx • Insulin
• Stop smoking • Drug treatments for
• Moderate complications
alcohol
consumption
• Exercise
Diet
M
weight
Pharmacological treatment
Cholestasis
rit Bizdefn
BP
lipid
Primary Secondary r
Age yoga
additional
Age yoyr
CVD risk factors
Insulin
Indications for insulin in type2DM
1. DKA, HHS
2. DM in pregnancy
3. DM in surgery
4. Critically ill patient
5. Uncontrolled sugar level despite maximum doses of three OHA were given
6. RBS>300mg/dl with osmotic symptoms
7. FBS>250mg/dl with osmotic symptoms
8. HbA1c >10%
Target sugar level
Insulin regimen (mark လုပ်တာကိုပဲမှတ်ထားရန်)
1
Basal insulin regimen
-
304
mix
Noro
Pre-mixed insulin regimen
St
30
200 101
3015
TED 151
Basal-bolus regimen
Side effects of insulin
E Y
Treatment in special circumstances
WE itioseif.eeR245
Insulin
Gestational DM
OGTT should be done in 24-28 week, HbA1C is not
useful
Target - pre-meal blood glucose levels of < 5.3 mmol/L (96 mg/dL) or
1-hour post-prandial level of < 7.8 mmol/L (142 mg/dL) or
2-hour post-prandial level of < 6.4 mmol/L (109 mg/dL)
Risk to fetus - caudral regression syndrome, CVS and renal abnormality
Risk to mother - retinopathy, pre-eclampsia
Treatment- insulin is prefer, Metformin, Glibenclamide are acceptable
Risk of type 2 DM - 15% in 5 years
0671 12wke after Me
