Diabetes mellitus (DM) is a common metabolic disorders where hyperglycemia is the predominant manifestation. It is a multi system disease because of the associated metabolic dysregulation. In United states DM is the leading cause of end-stage renal disease (ESRD), adult blindness and non-traumatic lower extremity amputations.It also increases the risk for cardiovascular disorders. Diabetes is a lifelong disease. Comprehensive diabetes care involves not only plasma glucose control, but also detect and manage DM-specific complications and modify its risk factors .
Treatment of diabetes:
Old concept
Involves only glucose control
Which prevent only microangiopathic complication.
Recent treatment
Comprehensive metabolic control, which control blood glucose and other metabolic disturbances
FPG - Fasting plasma glucose
PPG - Postprandial plasma glucose
HbA1C - hemoglobin A1C
LDL-C - Law density cholesterol
Tg - Tryglyceride
BP - Blood pressure
Following things needed to be monitored in diabetic patients
- Urine glucose has no value.
- Plasma glucose - Fasting or postprandial weekly.
- Glycated Hb - 8 to 12 weeks (RBC life–12wks), marker for long term control.
- HbA1C better co-relates with PPG than FPG.
- Monitor all 3 parameters (FPG, PPG, HbA1C).
- BP - In all sittings, every 3 months.
- Urine Albumin - Once in year.
- Lipid profile - Once in 6 months.
- Fundus/Foot exam - Once in a year.
Some blood glucose meters
