ADA 2013 Guideline :DM Goal
description
Transcript of ADA 2013 Guideline :DM Goal
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ADA 2013 Guideline :DM Goal
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ADA 2013 Guideline :DM Goal
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ADA 2013 Guideline :DM Goal
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Complications can be delayed and prevented by improving glucose control
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45% of Thai people with diabetes have poor to very poor glucose control
Results from nationwide study in 28.649 patients with diabetes from 602 hospitals across Thailand: NHSO, DM/HT Study, 2012; www.dmht.damus.in.th
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Tissue
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ตั�บอ่�อ่นตั�บ
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Glucose
Glucose
Glucose
Glucose
Insulin
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Tissue
ลำ��ไส้�เลำ�ก
ตั�บอ่�อ่นตั�บ
Glucose
Glucose
Glucose
Glucose
Insulin
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Glibencamide
Glipizide
Gliclazide
Metformin
PioglitazoneVogliboseSitagliptin
4
4
4
4/5
1.5
3
1
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1 .นางน�อยอาย� ๓๔ ปี� เปี�นเบาหวานมา ๒ ปี� ปีระจำ�าเดื�อนไม�มา ๒ เดื�อน แล้�วตรวจำ UPT Positive
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งดืยากิ นเบาหวานทั้"#งหมดื
เร $ม Insulin
ส่�งตรวจำ Retina
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๒ . นายส่มชาย ส่'ง ๑๕๘ ซม . น�#าหน"กิ ๙๘ กิกิ . อาย� ๒๙ ปี� ตรวจำส่�ขภาพปีระจำ�าปี� พบว�า FBS ๑๐๖ ม2แม�เปี�น DM
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Metabolic syndrome
ม2โอกิาส่เปี�น DM ๓๐ % ตอนอาย� ๔๐ปี�
ม2โอกิาส่เปี�น DM > ๘๐% ตอนอาย� ๕๐
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(๓) นางส่อเฉ้�งอาย� ๗๖ ปี� เปี�น DM มาเกิ�อบ ๒๐ ปี� แล้�ว
creatinine เม�$อ กิ�มภาพ"นธ์7 ๒๕๕๖ ไดื� ๑.๒๒ ญาต ไปีปีล้�กิตอนเช�าส่ล้9ม
ส่ล้�อ ไม�ต�$น พาไปีรพส่ต . ราไวย7 Dtx 44
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ยาทั้2$กิ นอย'� GB
1/2 x 2 Metformin
1x2Amlodipine
1x2ASA(81mg)
1x1BCO/ Folic
1x1
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Tissue
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Tissue
ลำ��ไส้�เลำ�ก
ตั�บอ่�อ่นตั�บ
Glucose
Glucose
Glucose
Glucose
Insulin
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Tissue
ลำ��ไส้�เลำ�ก
ตั�บอ่�อ่นตั�บ
Glucose
Glucose
Glucose
Glucose
Insulin
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Summary : Sitagliptin- Efficacy and Safety - No Hypoglycemia , No Weight gain- Compliace , OD (Half life 12.5 Hr.) - No drug interactions ( all combination)- Renal insufficiency - Mild (CrCl >= 50 ml/min) 100 mg - Moderate (CrCl >=30 to < 50 ml/min) 50 mg - Severe (CrCl < 30 ml/min) 25 mg ( US FDA 2006 )- Hepatic insufficiency - Mild to Moderate no dosage adjustment - No monitor hepatic enzyme - US FDA approved ,world wild
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SU
Insulin
Pioglit
Met
Sita
Vogli
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Met
Sita
Pioglit
Insulin SU
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ส่ว"ส่ดื2