Type 2 Diabetes - Screening, Diagnosis and Management Algorithm Lifestyle Modifications (Diet and Exercise) -> Start Oral Hypoglycemic (First Line: Metformin) -> Start Second Oral Hypoglycemic -> Start Basal Insulin qhs (D/C Secretagogues after starting insulin) -> Start PostPrandial Insulin A1c Targets: • 7.1 – 8.5 % - Recurrent severe hypoglycemia, Limited life expectancy, Frail elderly ± with dementia • 7.1 – 8.0 % - Functionally dependent • ≤ 7.0 % - Most adults • ≤ 6.5 % - Reduces Risk of Complications Risk Factors: • Age >= 40 • 1st degree relative with DM2 • High risk population (Aboriginal, Asian, South Asian, African, Hispanic) • History IFG, IGT • Presence of complications associated with DM • Presence of vascular risk factors (Dyslipidemia, Hypertension, Overweight, Abdominal obesity) • Gestational Diabetes OR macrosomic infant • Secondary Causes: Endocrinopathies (Cushing Syndrome, PCOS), Pancreatic Disease (CF, pancreatitis), Infections (CMV, Rubella) • Medications (Glucocorticoids, Atypical antipsychotics, HAART) - Amy Chung, MD, MSc @AmyChung #Diabetes #Screening #Targets #Management #algorithm #DM2 #DMII #Classification #primarycare
