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Diabetes Mellitus Type 2

Review some of the key elements in the diagnosis and treatment of DM 2.

AB
fasting glucose level = 126 mg/dl, or 200 mg/dl non-fastingthresholds for diagnosis of DM2
fasting glucose = 110-126, or 140-200 2-hr-postprandiallevels that identify impaired glucose tolerance
impaired insulin secretion, insulin resistancephysiologic defects that characterize DM2
renal disease, retinopathic changes, peripheral sensory deficitmicrovascular complications related to uncontrolled hyperglycemia
sulfonylureaincreases sensitivity of beta cells and stimulates insulin release
biguanideenhances tissue responsiveness to insulin
ACE inhibitorreduces proteinuria, slows progression of renal disease
Somogyirebound hyperglycemia after insulin-induced hypoglycemia
hemoglobin A1cassesses overall glycemic control for preceding 2-3 months
weight reduction to ideal body weightthe most important non-pharmacologic therapy


Dianne Miller-Boyle

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