drug therapy monitoring diabetes - Type 2 Diabetes Therapies A STEPS dokter memberikan resep obat diabetes dengan dosis 500 miligram Approach AAFP Glycemic management Target glycated hemoglobin A1C levels in patients with type 2 diabetes should be tailored to the individual balancing the anticipated reduction in microvascular complications over time with the immediate risks of hypoglycemia and other adverse effects of therapy A reasonable goal of therapy is an A1C value of 7 Type 2 diabetes in adults management Guidance NICE The goal A1C for most young people with type 2 diabetes is less than 7 percent 53 mmolmol which corresponds to an average blood sugar of approximately 150 mgdL 83 mmolL table 1 Lowering your A1C level reduces your risk for kidney eye and nerve problems For some people a different A1C goal may be more appropriate Scenario Management adults Management Diabetes type 2 CKS NICE 9 Pharmacologic Approaches to Glycemic Treatment Firstline drug treatment Also see the visual summary on firstline drug treatment for an overview of the recommendations and additional information to support medicines choice For adults with type 2 diabetes and chronic kidney disease follow recommendations on SGLT2 inhibitors in the section on chronic kidney disease in this guideline 173 Patients with blood pressure 14090 mmHg a single agent can be initiated Patients with blood pressure 16090 mmHg initial treatment should include a two drug therapy The choice of firstline antihypertensive drugs for patients with diabetes is controversial and not entirely based on the available literature Phung OJ Scholle JM Talwar M et al Effect of noninsulin antidiabetic drugs added to metformin therapy on glycemic control weight gain and hypoglycemia in type 2 diabetes JAMA 201030314 Initial management of hyperglycemia in adults with type 2 diabetes The US Food and Drug Administration FDA has now approved two hybrid closedloop pump systems The safety and mind map diabetes mellitus efficacy of hybrid closedloop systems has been supported in the literature in adolescents and adults with type 1 diabetes 1617 and recent evidence suggests that a closedloop system is superior to sensoraugmented pump therapy for glycemic control and reduction of hypoglycemia 9 Pharmacologic Approaches to Glycemic Treatment 9 Pharmacologic Approaches to Glycemic Treatment Diagnosis treatment and monitoring of hypertension is broadly the same for people with type 2 diabetes as for other people When a different approach is needed for people with type 2 diabetes this is specified in the hypertension guideline Offer standardrelease metformin as firstline drug treatment to adults with type 2 diabetes 2015 Type 2 diabetes in adults management NCBI Bookshelf Management of Type 2 Diabetes Mellitus NCBI Bookshelf When starting an adult with type 2 diabetes on dual therapy with metformin and an SGLT2 inhibitor as firstline therapy introduce the drugs sequentially starting with metformin and checking tolerability See the CKS topic on Hypertension for more information on monitoring blood pressure and drug treatment options Patient education Type 2 diabetes Treatment Beyond the Basics 91 Treat most adults with type 1 diabetes with continuous subcutaneous insulin infusion or multiple daily doses of prandial injected or inhaled and basal insulinA 92 For most adults with type 1 diabetes insulin analogs or inhaled insulin are preferred over injectable human insulins to minimize hypoglycemia riskA 93 Early use of continuous glucose monitoring is recommended for 91 Most individuals with type 1 diabetes should be treated with multiple daily injections of prandial and basal insulin or continuous subcutaneous insulin infusionA 92 Most individuals with type 1 diabetes should use rapidacting insulin analogs to reduce hypoglycemia riskA 93 Individuals with type 1 diabetes should receive education on how to match design peringatan hari diabetes sedunia mealtime insulin doses to
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