Diabetes mellites

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1. Diagnostic criterion:

    1. FBS>126

    2. HbA1c>6.5

    3. 2hpp>200

    4. Random BS>200 + typical symptoms

    5. if one is positive, repeat it or use two of them to confirm diagnosis

2. Treatment

    1. Tab metformin 500 mg qd #30 (increase every 2 week about 500 mg daily, max dose/day 2 gr)

    2. Tab gliclazide 30 mg #30 before meal

    3. or Tab sitagliptin 50 qd #100

    4. Tab Zipmet (Metformin + sitagliptin) 50/500 or 50/1000 mg

3. Insulin

    1. start when after triple therapy:

        1. BS is not well controlled

        2. GFR<30

        3. high Cr

        4. FBS>250 from beginning

    2. Start with 0.3-0.4 u/kg

    3. Vial insulin regular

    4. vial insulin NPH

4. Goal of treatment

    1. FBS<130 check every 2 weeks

    2. HbA1c<7 check every 3 month

    3. 2hpp<180