Wednesday, February 6, 2013

AMERICAN DIABETES ASSOCIATION AND THE EUROPEAN ASSOCIATION FOR THE STUDY OF DIABETES UPDATED THE ALGORITHM FOR DIABETES TREATMENT IN 2012.

The new algorithm suggest
1. lifestyle modification (diet and physical exercice)
2. Metformin; REDUCE RELEASE OF GLUCOSE BY THE LIEVR, NO WEIGHT GAIN
3.Sulfonylureas (Glimepiride,Glipizide (Glucotrol), Glyburide(Micronase) are secretaogogue complicated by hypoglycemia and weight gain
4.Thiazolidinediones(glitazones) (Actos and Avandia)  Avandia has Heart attack concerns and is of limited use in the US..Weight and fluid retention are of concern
5.GLP-1 Receptor Agonist:  Glucagon like peptide increases secretion of Insulin by the pancreas, decreases Glucagon, increase sens of satiety and therefore weight loss.
5.DPP-4 Inhibitor, blocks GLP-1 degradation, and therefore behave as inhibitor of GLP1
6.Insulin
other meglitinides (to be taken 30 min before the meal because they are short acting "Sulfonylureas like", alpha Glucosidase Inhibitors (slow degradation of larger carbohydrates to slow the spike of Glucose in the blood)  ,Colesevelam (Anticholesterol that slow down absorption of glucose in the gut), Bromocriptine (effect on circadian control of hormones) and pramlintide (Amilin like, regulate gllucose after meal).  (to be continued)

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