|Random blood glucose(RBG)||> 200 mg/dl or 11.1 mmol||It requires a second confirmatory test.|
|Fast blood glucose (FBG) for 8 hrs||> 200 mg/dl or 11.1 mmol|
Diabetes is a chronic disease requiring continuous multidisciplinary management strategies. It depends primarily on patient self-management and clinical support for acute or chronic critical hypo- or hyperglycemic complications.
Note: Glycemic control is a patient-centric plan. Physicians should personalize the management plan based on patient preference.
|Caloric intake.||Affects the medications dosage.|
|Metabolism rate.||Affects the medications dosage.|
|Financial/insurance coverage.||Affects medication choice.|
|Medication/plan compliance.||Affects medication choice and the dosage.|
|The patient lifestyle.||Affects medication choice and the dosage.|
|Drug interactions.||Affects medication choice.|
|Comorbidities.||Affects medication choice.|
|Acceptable side effects.||Affects medication choice and the dosages.|
|Oral pharmacology vs Insulin regimen||Affects medication choice.|
Level 1 is a monotherapy.
Level 2 is dual-combined therapy.
Level 3 is triple-combined therapy.
If the set of recommendations failed to reduce FBG <130 mg/dl and/or HbA1c in 3 months, go to the next level
|HbA1c < 7-10%||Achieved through controlling caloric intake, metabolism, and/or prandial insulin regimen.|
|FBG < 130 mg/dl||Achieved through adequate basal insulin coverage. Either through non-insulin or insulin regimen.|
|Pre prandial BG < 130 mg/dl||Achieved through adequate prandial insulin regimen, and caloric control.|
|Reduce macro and microvascular complications||Achieved through HbA1c < 7-10%|
|Reduce the risk of hypoglycemia & nocturnal hypoglycemia.||Achieved through appropriate medication choices, dosages, and patient education.|
|Patient satisfaction and good mental health.||Achieved through adequate and open conversation with the patient; about his needs, goals, and lifestyle.|
☆ is the level of effectiveness on HbA1c, in comparison to other agents.
$ is the average cost representation in comparison to other agents.