Diabetes and DKA

 Diabetes Mellitus type 2

that day we discussed with MO and he teach us something new, would like to share it to everyone here who is interested and also a reminder to myself. 

Question : how do we know when to give OHA or insulin in a patient.

Diagnosis criteria

- if symptomatic, one abnormal glucose is diagnostic

- if a asymtomatic, 2 abnormal glucose values required

• symptoms of hyperglycemia
• Fasting blood glucose: >7mmol/L
• Random blood glucose : > 11.1mmol/L (at 2 occasions)
• HbA1c: > 6.4 prediabetic

Targets

• fasting BG: 4.4-6.1
• non fasting 4.4-8
• HbA1c <6.5
• LDL<1.7, HDL<1.1, LDL<1.4(for pt with IHD) <2.6(for normal adult)
• exercise: 150min/wk
• BP: <130/80 (normal renal function), <125/75 (renal impaired)

Types of diabetic medication

New oral hypoglycemic agents (OHA):

- AGIs (acarbose): prevent carbohydrate absorption
- DPP4 inhibitor- sitagliptin: to excrete sugar from urine

reference: https://pubmed.ncbi.nlm.nih.gov/10989161/