Epidemiology and Diagnosis A Practical Guide to Therapy Monotherapy Combination Therapy Add ons.

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Epidemiology and Diagnosis A Practical Guide to Therapy Monotherapy Combination Therapy Add ons

Transcript of Epidemiology and Diagnosis A Practical Guide to Therapy Monotherapy Combination Therapy Add ons.

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Epidemiology and Diagnosis

A Practical Guide to Therapy

Monotherapy

Combination Therapy

Add ons

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Impaired GlucoseTolerance - IGT

Impaired FastingGlucose - IFG

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Beta cell mechanism

Insulin secretion and Glucose regulation

Effects of hyper glycemia

Biphasic Insulin response

Insulin secretagogues

Glycaemic goals & Pregnancy

Diabetic retinopathy

Glitazones

Hyperglycemia

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Etiologic classification of diabetes mellitus

Glucose tolerance categories

Diagnosis of Diabetes

Diagnosis of Diabetes II

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Management Goals

Metabolic Targets

Deterioration in Median

Antihyperglycemic Agents

Antihyperglycemic Agents(Sites)

Antihyperglycemic Agents(Mechanism)

The -Glucosidase inhibitors

The -Glucosidase inhibitors(Effect)

Acarbose Effect on HbA1c

The Biguanides(Characteristics)

Metformin (Mechanism)

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Metformin Effect(Glucose)

Metformin Effect(HbA1c)

Dose Response(Metformin)

Insulin Secretagogues

Repaglinide Effect(HbA1c)

Repaglinide after Sulfonylurea

Sulfonylurea Effect(Glucose)

Dose Response(Sulfonylurea)

Once vs Twice daily(Sulfonylurea)

Placebo subtracted dose

Selected insulin secretagogues

-Glucosidase Dosing

Hypoglycemic episodes

Sulfonylureas

Insulin Secretagogues

Initial treatment

Secondary Failures

Metformin

-Glucosidase Inhibitors

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Glycemic Improvements

Sulfonylurea+Metformin

Sulfonylurea+Acarbose

Combinations of Oral agents

Secondary Failure

Metformin+Repaglinide

Metformin+Acarbose

Glimepride+Insulin(FPG)

Glimepride+Insulin(HbA1c)

Oral Agents+Insulin

Sulfonyurea+Insulin

Insulin+Metformin(HbA1c)

Insulin+Metformin(Effect)