Type-2 Diabetes
Personalize glycemic targets for patients with diabetes
As a clinical pharmacist, people with diabetes will rely on your help to tailor A1c goals and decipher continuous glucose monitoring (CGM) metrics. Continue to emphasize individualizing glycemic goals, explain that a “one-size-fits-all” approach isn’t safe, practical, or recommended... A1c. Rely on A1c to asses…
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Hyperglycemia
Manage HYPERglycemia in hospital
H yperglycemia was defined as a fasting or admission blood glucose > 126 mg/dL or a random blood glucose > 200 mg/dL. Serum blood glucose control should be done with basal and bolus insulin, with additional coverage with slide scale (correction insulin). Avoid sliding scale insulin alone as it associated with worse outcome. Glycemic control Ben…
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Type-2 Diabetes
Manage diabetes medications during fasting
How should diabetes medications be managed while fasting? Fasting for morning labs usually doesn't require adjustments. But other fasts vary. For example, patients may fast from dawn to dusk during Ramadan or from sundown to sundown during Yom Kippur or 18 hours/day with some intermittent fasting diets. Help individualize a plan based on medications, and fast dur…
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Type-2 Diabetes
Preventing and treating hypoglycemia in patients with type 2 diabetes
As a pharmacist, you'll see more emphasis on preventing and treating hypoglycemia in patients with type 2 diabetes, not just type 1. We all know that hypoglycemia can lead to confusion, seizures, and emergency room visits. But it can also impact driving, sleep, or work. Help your diabetes patients prevent and manage hypoglycemia... …
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Type-2 Diabetes
Prevention and treatment of diabetic foot infections
As a pharmacist, you'll see more focus on prevention and treatment of diabetic foot infections. More than half of foot ulcers in diabetes patients develop into diabetic foot infections... Recommend choosing empiric antibiotics based on infection severity and likely pathogens. For mild infections, recommend oral antibiotics that cover strep and S. aureus. Suggest …
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Type-2 Diabetes
Pharmacotherapy of type 2 diabetes
Overview ㅡ Effective treatment of type 2 diabetes is uniquely challenging because it encompasses management of lifestyle factors ( including diet, exercise, and weight control ), use of multiple oral or injectable medications, self-monitoring of blood glucose concentration, and surveillance and treatment for acute and chronic diabetic complications. Goals of Ther…
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Type-2 Diabetes
Management of diabetes mellitus in primary care
SCREENING AND PREVENTION ㅡ Screen asymptomatic patients at increased risk for diabetes mellitus (family history of diabetes in twin, sibling, or parent, obesity, gestational diabetes and history of impaired glucose tolerance). Use fasting glucose determination; fasting test is preferred since it is most sensitive of methods appropriate for asymptomatic adult populati…
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Surgery
Preop mgmt of diabetes meds in pts undergoing surgery
Overview ㅡ The goal is to help prevent the blood glucose seesaw. Consider these strategies, but be aware, evidence is lacking for the best preoperative glucose targets or protocols for diabetes medications. Continue to recommend avoiding tight blood glucose control around surgery to limit hypoglycemia. Generally aim to keep glucose below 180 mg/dL or lean toward less…
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