1.DM

Goals


#Short-term goal: Preventing acute complications from high blood glucose levels; Premeal plasma glucose goal 70-130 mg/dL; peakpostprandial plasma glucose goal <180 mg/dL; A1c <7% initially.
#Long-term goal: Reducing, controlling, and managing long-term microvascular, microvascular, and neuropathic complications;preserving beta-cell function; minimizing hypoglycemic episodes; and maintaining the patient's overall quality of life.

List of options

#Nonpharmacologic therapy*Medical nutrition therapy*Dietary supplements

*Weight management
*Physical activity
*Psychological assessment and care
*Immunizations

#Sulfonylureas
*Systemic, first-generation (acetohexamide, chlorpropamide, tolazamide, tolbutamide)
*Systemic, second-generation (glyburide/glibenclamide, gliclazide, glipizide, glimepiride)

#Nonsulfonylurea secretagogues
*Systemic, glinides/meglitinides (nateglinide, repaglinide)

#Biguanides
*Systemic (metformin)

#Thiazolidinediones
*Systemic (pioglitazone)

#alpha-Glucosidase inhibitors
*Systemic (acarbose, miglitol)

#DPP-4 inhibitors
*Systemic (sitagliptin, saxagliptin, linagliptin)

#Central-acting dopamine agonist
*Systemic (bromocriptine mesylate)

#Bile acid sequestrants
*Systemic (colesevelam)

#Insulin
*IV systemic, rapid acting (regular insulin)
*Subcutaneous systemic, rapid acting (regular insulin, lispro, aspart, glulisine)
*Subcutaneous systemic, intermediate-acting (neutral protamine, hagedorn)
*Subcutaneous systemic, long-acting (Glargine, Detemir)
*Subcutaneous systemic, combination insulin products (neutral protamine and regular, hagedorn and regular, neutral protamine andlispro, neutral protamine and aspart)
*Pump (regular insulin, lispro, aspart, glulisine)

#Glucagon-like peptide 1 agonists
*Subcutaneous systemic (pramlintide, exenatide, liraglutide)