Management of Diabetes Mellitus

Wikis > Diabetes > Management of Diabetes Mellitus

Diabetes mellitus is chronic metabolic illness that needs a large spectrum of interventions to prevent the development of the acute and chronic complications.

Principles of management:

Management of type 1 diabetes:
Use of exogenous insulin for glycaemic control (type 1 is fatal without insulin)
Education in self management
Self-monitoring of blood glucose (SMBG)
Specific measures to manage complications

Management of type 2 diabetes:
Control symptoms
Education in self management
Obtain reasonable glycaemic control (exercise, diet, drugs)
Reduce risk factors for macrovascular and macrovascular disease
Detect (screening) and treat complications early

Aim to:
Reduce random blood glucose levels 4 – 8 mmol/L (“fine line” between good or tight glycaemic control and the avoidance of the chronic and acute complications)
HbA1c < 7% (supported by evidence from DCCT & UKPDS) Cholesterol < 5.5mmol/L (aggressive management of dyslipidaemia reduces risk of macrovascular disease; Haffner, 1998) Blood pressure 140/90 or less (strong correlation between hypertension and adverse outcomes in diabetes) BMI <25kg/m2 Cigarette consumption = 0 (higher risk of macrovascular disease and mortality in those that smoke; ) Alcohol consumption < 2 standard drinks a day Exercise at least 20 minutes, 4+ days/week

Comments are closed.