diabetes in the 21 st century 2010 update l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Diabetes in the 21 st Century 2010 Update PowerPoint Presentation
Download Presentation
Diabetes in the 21 st Century 2010 Update

Loading in 2 Seconds...

play fullscreen
1 / 12

Diabetes in the 21 st Century 2010 Update - PowerPoint PPT Presentation


  • 154 Views
  • Uploaded on

Diabetes in the 21 st Century 2010 Update. American Diabetes Association 2010 Guidelines – Diagnostic Criteria. A1C > or = 6.5% is included as diagnostic criteria for diabetes. A1C = 5.7- 6.4 – at increased risk for diabetes

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Diabetes in the 21 st Century 2010 Update' - dagmar


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
american diabetes association 2010 guidelines diagnostic criteria
American Diabetes Association 2010 Guidelines – Diagnostic Criteria
  • A1C > or = 6.5% is included as diagnostic criteria for diabetes.
  • A1C = 5.7- 6.4 – at increased risk for diabetes
    • Must be done by a lab method with appropriate certification and standardization. Point of care testing does not qualify.
american diabetes association 2010 guidelines treatment goals
American Diabetes Association 2010 Guidelines – Treatment Goals
  • A1C < 7% in general, non-pregnant adult population.
  • In select persons may target closer to normal - if can be achieved without significant risk of hypoglycemia or adverse events (i.e.: persons with diagnosis of short duration, long life expectancy, no history of CVD)
american diabetes association 2010 guidelines treatment goals4
American Diabetes Association 2010 Guidelines – Treatment Goals
  • Conversely, less stringent goals may be appropriate for patients with history of hypoglycemia, limited life expectancy, advanced complications, extensive co-morbidities or difficult to control despite multiple modalities.
american diabetes association 2010 guidelines dietary guidelines
American Diabetes Association 2010 Guidelines – Dietary Guidelines
  • ADA comments that the use of glycemic index and glycemic load may add modest benefit for glycemic control over consideration of total carbohydrate alone.
  • Optimal mix of macronutrients remains unclear. Several studies have demonstrated some benefits of short term use of low carbohydrate diets (<130 Gm/day) with weight loss, improved HDL and triglycerides, or improved A1C, however long term metabolic effects remain unclear and monitoring is warranted.
american diabetes association 2010 guidelines dietary guidelines6
American Diabetes Association 2010 Guidelines – Dietary Guidelines
  • Continued support of limiting intake of saturated fats to less than 7% total caloric intake and minimizing trans fats
  • Total caloric intake must be appropriate for the weight management goal
american diabetes association 2010 guidelines exercise
American Diabetes Association 2010 Guidelines - Exercise
  • 150 min per week of moderate intensity (or 75 min vigorous intensity)
  • In absence of contraindications, adding resistance training 3 times a week has been shown to reduce insulin resistance
medication update
Medication Update
  • Avandia remains in limelight.
  • Controversy regarding evidence of increased risk of cardiovascular morbidity and mortality. Are the risks greater than the benefits?
  • As of September 2010, FDA has determined to allow to remain on market with significant restrictions
  • Patients should be advised not to stop Avandia without consulting with their diabetes health care provider, but to discuss treatment changes as appropriate.
  • TZDs as a class are also noted to increase bone loss and risk of fracture.
medication update9
Medication Update
  • Liraglutide (Victoza) – GLP1 receptor agonist
    • Similar effects, side effects and cautions as exenatide (Byetta)
    • Once a day subcutaneous dosing (start with 0.6 mg/day, increase to 1.2 mg/day after 1 week, can titrate up to 1.8 mg/day). Can be dosed at any time of day
medication update10
Medication Update
  • GLP1 receptor agonists noted to have a risk of pancreatitis – screen for history of pancreatitis, gallstones, alcohol abuse or hypertriglyceridemia as contraindications.
  • Byetta has had post marketing reports of acute renal insufficiency and renal failure. Monitor kidney function at initiation and with dose increases.
medication update11
Medication Update

New DPP4 inhibitor

  • Saxagliptin (Onglyza)
    • Effects, side effects and cautions similar to sitagliptin (Januvia)
    • Dosing 2.5 – 5 mg PO QD
slide12

Resources:

NMTOD Diabetes Compendium http://nmtod.com/diabetesresources.html

American Diabetes Association (2010). Standards of medical care in diabetes – 2010. Diabetes Care, 33, s11-s61. Retrieved August 17, 2010 fromhttp://care.diabetesjournals.org/content/33/Supplement_1/S11.full.pdf+html.