diabetes center

INSULIN MANAGEMENT

Insulin therapy is recommended for patients with type 2 diabetes mellitus and an initial A1C level greater than 9 percent, or if diabetes is uncontrolled despite optimal oral glycemic therapy. Insulin therapy may be initiated as augmentation, starting at 0.3 unit per kg, or as replacement, starting at 0.6 to 1.0 unit per kg. When using replacement therapy, 50 percent of the total daily insulin dose is given as basal, and 50 percent as bolus, divided up before breakfast, lunch, and dinner. Augmentation therapy can include basal or bolus insulin. Replacement therapy includes basal-bolus insulin and correction or premixed insulin. Glucose control, adverse effects, cost, adherence, and quality of life need to be considered when choosing therapy. Metformin should be continued if possible because it is proven to reduce all-cause mortality and cardiovascular events in overweight patients with diabetes.

In a study comparing premixed, bolus, and basal insulin, hypoglycemia was more common with premixed and bolus insulin, and weight gain was more common with bolus insulin. Titration of insulin over time is critical to improving glycemic control and preventing diabetes-related complications

  • QUALIFIED DIABETOLOGIST
  • INHOUSE HEART SPECIALIST
  • ADVANCED CARDIO-DIABETIC
  • ASSESSMENT – HEART RATE VARIABILITY TEST
  • INHOUSE PATHOLOGY & PHARMACY
  • PERIODIC ECG & CARDIAC TESTING
Need for Cardiac Testing & Management for Diabetics
Diabetics in general have a higher risk of heart ailments. Studies have suggested that 60% of diabetic patients above the age of 65 years are at a risk of heart attack. Over the past few years we are increasingly seeing this in younger population. The central pathological mechanism in Heart disease is atherosclerosis. Atherosclerosis is known to lead to coronary heart disease and cardiovascular events. With close to 70% mortality, cardiovascular disease (CVD) is the leading cause of death in people with type 2 diabetes. The risk factors of CVD are age, obesity, tobacco use, dyslipidaemia, and hypertension. Diabetes itself is an independent risk factor of CVD.1Depending on the types of combination of risk factors such as genes and lifestyle you get either type-1, type-2 diabetes. Although risk factors such as family history, age, or ethnicity can’t be changed you can modify your lifestyle to lower the risk factors by eating well, physical activity, and weight management. In women Polycystic ovary syndrome can also increase the risk of diabetes. Even if your blood glucose stays high over time can cause your blood vessels towards retina to swell.