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Grand Rounds 09/25/13 @ BID-Needham - Greeshma K. Shetty, MD  

Type 2 Diabetes: Optimizing Medical Management in 2013
Last Updated: Aug 12, 2014 URL: http://bidmc.libguides.com/Shetty Print Guide RSS Updates
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Speaker: Date: Topic

Greeshma K. Shetty, MD

Sep 25, 2013

Type 2 Diabetes: Optimizing Medical Management in 2013

      

    Responsibility for Contente

    The take-away points and article links were sent by the Medical Library and the CME Committee.

    Diane E. Young, Information Specialist

    dyoung3@bidmc.harvard.edu

     

        

      Take-Away Points of the Presentation

      1. Type 2 Diabetes Mellitus affects 25.8 million people in the United States; in particular, it affects 26.9% of people over the age of 65. Diabetes carries an increased risk for heart disease, stoke, hypertension, blindness, kidney disease, nervous system disease, and amputations. Studies in the US and abroad have found that improved glucose control benefits people with either type 1 or type 2 diabetes. In general, every percentage point drop in A1C blood test results can reduce the risk of microvascular complictions -- eye, kidney, and nerve diseases.

      2. Type 2 Diabetes is most frequently detected by primary care physicians (PCPs) when a higher than normal glucose level or HbA1c is noted at a yearly physical in an unsuspecting patient. Given that PCPs are those who most frequently detect and initially treat type 2 diabetes, it is essential that they are educated in the proper work-up, treatment options, and follow-up for these patients.

      3. Initial treatment for type 2 diabetes consists of education and lifestyle modifications, namely, nutrition, exercise and weight loss. Monotherapy with Metformin is indicated in most patients; some patients do require insulin treatment initially at time of diagnosis. Most patients have improved glucose control initially,but with time due to progressive beta cell dysfunction other treatments need to be considered and added to the treatment regimen. There are many medications to chose from, including: Sulfonylureas, Meglitinides, Thiazolidinediones, DPP-IV inhibitors, Glucagon-like peptide 1 agonists, Alpha-glucosidase inhibitors, and Insulin.

          
         

        Links to Articles Cited in the Presentation

        Obtaining the PowerPoint Presentation

        Contact Lauren Oliva at loliva@bidneedham.org

         

            
           

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