The blood glucose management algorithm for type 2 diabetes outlines the risks, benefits and costs of available therapies and provides an approach for how to incorporate older and newer agents. Standards of medical care in diabetes2012 diabetes care. This practice consensus algorithm is based on majority expert opinion of hypoglycemia work group at the university of texas md anderson cancer. Due to its increasing incidence and economic impact related to the treatment and associated morbidity, effective management and prevention is key.
It is not a substitute for the knowledge and information provided by complete national guidelines or the ihs diabetes standards of care for patients with type 2 diabetes. Treatment algorithms and the pharmacological management of. Treatment algorithm american association of clinical. Lipid algorithm for type 1 and type 2 diabetes mellitus in adults revised. As per algorithm for management of type 2 diabetes but consideration around. Australian blood glucose treatment algorithm for type 2 diabetes. Shubrook do facofp professor primary care department director of clinical research and diabetes services touro university california eric l. How to use adas type 2 diabetes treatment algorithm. This increase relates, in part, to the increasing age of the population, an increase in obesity and also perhaps to increasing survival of those with diabetes. The effect of intensive treatment of diabetes on the development and progression of longterm complications in insulindependent diabetes mellitus. The diabetes control and complications trial research group.
The 2020 standards of medical care in diabetes includes all of adas current clinical practice recommendations and is intended to provide clinicians, patients, researchers, payers, and others with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care. If hba1c 58 mmolmol or individually agreed target step 4 injectable with combinations refer to injectable pathway for further. No patient starts here iv insulin infusion protocol for criticallyill adult patients in the icu setting diabetes treatment algorithms. Type 1 diabetes treatment guideline kaiser permanente. The canadian diabetes association is the registered owner of the name diabetes canada. Although patients with type 1 diabetes most commonly present with abrupt onset of symptoms and weight loss, type 1 diabetes can occur in patients at any age and weight.
The diabetes treatment algorithms are intended to serve as a tool to enhance the information required in treating patients with type 2 diabetes. Evaluation and management mar 1, 2020 issue figure 1. Prediabetes algorithm ace i igt 140199 metabolic syndrome ncep 2001 lifestyle therapy including medically assisted weight loss treat hyperglycemia fpgioo 1 2hour pg 140 weight loss therapies normal glycemia progression overt diabetes proceed to glycemic control algorithm 1 predm criterion intensify weight loss therapies. No patient starts here without authorization from the endocrine service. Insulin algorithm for type 1 diabetes mellitus in children and adults revised. Medical treatment of diabetes mellitus cleveland clinic. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. Standards of medical care in diabetes2019 abridged for. Evans jm, newton rw, ruta da, macdonald tm, stevenson rj, morris ad. Type 1 diabetes mellitus is a metabolic disorder characterized by hyperglycemia due to absolute insulin deficiency. American diabetes association treatment algorithm for type 2 diabetes diagnosis of type 2 diabetes counsel patients regarding lifestyle modification weight loss, exercise expected decrease in hba1c 12% and initiate metformin glucophage, others 500 mg once or twice daily.
Associate professor university of north dakota school of medicine and health sciences assistant medical director altru diabetes. Educate patients to drive safe with diabetes quick reference. Sep 15, 2016 at present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus t2dm. Diabetes mellitus is a chronic illness that requires continuing medical care and ongoing patient selfmanagement education and support to prevent acute complications and to reduce the risk of longterm complications. Startmetforminifa1cabovepatientstargetbut diabetes treatment algorithms were developed to provide clinicians with a quick reference to treatment algorithms based on national guidelines and the standards of care and clinical practice recommendations. Diabetes is a major cause of morbidity and mortality in scotland and worldwide, with an increasing prevalence. Algorithm for the management of type 2 diabetes step 1 initial drug treatment. Blood glucose treatment algorithm for type 2 diabetes.
Choice of second line agent should be guided by clinical considerations presence of, or high risk of cardiovascular disease, heart failure, chronic kidney disease, hypoglycaemia, side effect profile, contraindications and cost. Jnc 8 hypertension guideline algorithm initial drugs of. Diabetes treatment algorithms iv insulin infusion protocol. How to use adas type 2 diabetes treatment algorithm part two. Practice guidelines resources american diabetes association. How to use adas type 2 diabetes treatment algorithm carlos mendez, md, facp presenter disclosure information in compliance with the accrediting board policies, the american diabetes association requires the following disclosure to the participants. American diabetes association treatment algorithm for type 2. Nottinghamshire health community treatment guideline for.
This algorithm should not be used to treat pregnant women. Australian blood glucose treatment algorithm for type 2 diabetes the national diabetes services scheme is an initiative of the australian government administered with the assistance of diabetes australia. This guideline recommends avoiding the term pre diabetes because not all patients with igt andor ifg will develop diabetes. Recommendations ensure treatment decisions are timely, rely on evidencebased guidelines, and are made collaboratively with patients based on individual preferences, prognoses, and comorbidities.
A large body of evidence exists that supports a range of interventions to improve. Fortunately, several longterm, prospective studies have demonstrated how proper medical management can significantly reduce the risks associated with diabetes. Treatment algorithms comprehensive type 2 diabetes management algorithm 2020 executive summary this algorithm for the comprehensive management of persons with type 2 diabetes t2d was developed to provide clinicians with a practical guide that considers the whole patient, his or her spectrum of risks and complications, and evidencebased. Jun 30, 2014 diabetic ketoacidosis dka is a rare yet potentially fatal hyperglycemic crisis that can occur in patients with both type 1 and 2 diabetes mellitus.
Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. Patients most often present with a few days or weeks of polyuria, polydipsia, weight loss, and weakness. Startmetforminifa1cabovepatientstargetbut treatment guideline for the management of type 2 diabetes t2d these guidelines are intended to support prescribers regarding the medicines aspects of the type 2 diabetes algorithm, please refer to the bnf or. Treatment algorithm for helicobacter pylori infection.
Associate professor university of north dakota school of medicine and health sciences. Startmetforminifa1cabovepatientstargetbut treatment of type 2 diabetes ii. Complicationscentric model for care of the patient with overweightobesity iv. The american diabetes association ada standards of medical care in diabetes includes the adas current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. How to use adas type 2 diabetes treatment algorithm jay h. How to use the ada type 2 diabetes treatment algorithm eric l. This collection features afp content on type 2 diabetes and related issues, including blood glucose levels, diabetic complications such as ketoacidosis and neuropathy, glycemic control, insulin. A1c diabetes, including for patients diagnosed with impaired glucose tolerance. Algorithm for the management of type 2 diabetes step 1 initial drug treatment monotherapy. Carlos mendez, md, facp disclosed no conflict of interest.
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