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    2 views11 pages

    Aace Algorithm Slides

    Uploaded by

    Alfitra Halil

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF or read online from Scribd
    Flag for inappropriate content
    of 11
    AACE/ACE COMPREHENSIVE TYPE 2 DIABETES MANAGEMENT ALGORITHM — x= ‘Martin Abrahamson, MD Joshua | Baily, MO, FACE Lawrence Blonde, MO, FACP FACE Zachary. Bloomgarden, MD, MACE Michae! A. Bush, MD ‘Samuel Dagogo-Jack, MD, DN, FRCP, FACE Ralph A, Defronzo, MD TASK FORCE Alan J. Garber, MD, PhD, FACE, Chair Daniel Einhorn, MD, FACR, FACE Vivian A. Fonseca, MD, FACE Jeffrey R. Garber, MD, FACR, FACE Wi Timothy Garvey, MD, FACE George Grunberger, MD, FACP, FACE Yehuda Handelsman, MD, FACP.FNLA, FACE Robert R. Henry, MO, FACE eB Hitsch, MD Paul S.Jelinger, MD, MACE Janet BMG, MD, FACE Jere l Mechanick, MD, FACP, FACE, FACN, ECNU Paul D. Rosenblit, MD, PHD, FNLA, FACE Guillermo Umpierrez, MD, FACE, FACE TABLE OF CONTENTS COMPREHENSIVE TYPE 2 DIABETES ALGORITHM Il IV. Vi. VIL. VIL. IX. LIFESTYLE THERAPY COMPLICATIONS-CENTRIC MODEL FOR CARE OF THE OVERWEIGHT/OBESE PATIENT PREDIABETES ALGORITHM GOALS FOR GLYCEMIC CONTROL GLYCEMIC CONTROL ALGORITHM ALGORITHM FOR ADDING/INTENSIFYING INSULIN ASCVD RISK FACTOR MODIFICATIONS ALGORITHM PROFILES OF ANTIDIABETIC MEDICATIONS PRINCIPLES FOR TREATMENT OF TYPE 2 DIABETES Physical pong ae roo ry erry GDS CL! lal eG RISK STRATIFICATION FOR DIABETE Maintain optimal weight Calorie restriction Plant-based dit; high polyunsaturated and monounsaturated fatty acids ‘Avoid trans faty acids limit saturated fatty acids 150 min/week moderate exertion (eg. walking stair climbing) Strength traning Increase as tolerated About 7 hours per night Community engagement Seteen for mood disorders No tobacco products COMPLICATIONS Structured counseling Meal replacement Medical evaluation/ clearance Medical supervision structured program Screen for obstructive sleep apnea Refer to mental healthcare professional Behavioral therapy Structured programs 6) COMPLICATION ENTRIC MODEL FOR CARE OF THE OVERWEIGHT/OBESE PATIENT EVALUATION FOR COMPLICATIONS AND STAGING Perec Cue BMI 225 BMI = 27: Stage Sever wiLo To MODERATE t t t — Treatment _{__Tieatment testy based + + + Ree Physician/RD counseling, web/remote program, structured multidisciplinary program of Complications = > eee (Cera _— Surgical Therapy (BMI = 35) If therapeutic targets for complications not met, intensify lifestyle, medical, and/or surgical treatment UAE modalities for greater weight loss. PREDIABETES ALGORITHM 100-125) | IGT (140-199) | METABOLIC SYNDROME (NCEP 2001) ae aD) WEIGHT Loss, UNNI Pazar THERAPIES FPG > 100 | 2-hour PG> 140 ASCVD RISK FACTOR 1 PRE-DM. MULTIPLE PRE-DM MODIFICATIONS ALGORITHM CRITERION CRITERIA DYSLIPIDEMIA HYPERTENSION ROUTE ROUTE, oa or tentrmerapaae rea) 7 omeroeppn agi 3. sro IFalycemia eh seca see rE not normalized S FORSGRSEMIG CONTROL INDIVIDUALIZE G A1C < 6.5% A1C > 6.5% For patients without For patients with concurrent serious concurrent serious illness and at low illness and at risk hypoglycemic risk for hypoglycemia EMIC CONTROL ALGORITHM a sc Cee SLF2i Tv se 7 PP. scur2i - 5 on ,= | MET On basa sn p , nse Cotesevelan a ‘Bromocriptine OR ( Colesevelam Bat SU/GLN 9 + Bromocriptine OR Lh ADD OR INTENSIFY AGL INSULIN fer to nslin Algorithm su/atn (| kee ee SORITHM FOR ADDING/INTENSIFYING INSULIN 4 START BASAL (Long-Acting Insulin) INTENSIFY (Prandial Control) Peas Eagee cry COC ey co Cectey age Lt tee Insulin titration every 2-3 days. to reach glycemic goal: + Begin prandl + Begin prandil mens insula before Insulin before oer Cen largest meal each meal a arte + Hfnotat goa, + 50% Basal era progress to 50% Prandial Injections before Top 03-05 Uikg 20r3 meals ee eee ISK FACTOR MODIFICATIONS ALGORITHM na DYSLIPIDEMIA aaa a oh fice GOAL: SYSTOLIC <130, DIASTOLIC <80 mm Hg I tatinintoierant ‘Ty aternate statin. tower stan Aepeatipi pane Antena therapies to a deseo ranean seat stamgnaacoring Acti snd lowering therapies tolerance of therapy torskleves ve reer IT cy Coord Tg cls oe Ag gee eee =A Dla <0 7 ifnotat goal (2-3 months) {00> ah 0

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