Needs to control blood sugar , pressure, lipid, weight ,early identification and of complications and treat them early .
To achieve them , pharmacological management with metformin , sulfonylurea ,SGLT2I , DPP4I , GLP1 , acarbose , thiazolidine ,insulin and combination
ACEI if high BP
statin for cholesterol target
lifestyle modifications is the key like diet exercise safe alcohol no smoking with a target of 5-10% weight loss in 3-6 months .
diet 5 portion of veg and 3 portions of fruits per day low CHO, low fat diet , Consumption of cereal food and at least 1.5 serves/day of dairy foods
exercise 30 min/day 5 days a weeks minimum 150min/day arobic with 2-3 sessions / week of resistant exercise additionally not in consecutive days
alcohol <2 SD at least 2 alcohol free days with no Bing at all
no safe level for smoking
Target BP 130/80, HBA1C 7, TC 4 LDL 2
Compliance in medication adherence to life style alteration is very important
Refer podiatrist , optometrist ,dietitian diabetic educator exercise physiologist (PODDE) regularly under GPMP
HBA1C, EGFR , LP, ACR, (HELA) annually , dilated fundus –yearly , foot 6 monthly ,
Diabetic cycle of care , hypoglycaemic action plan , HBSM , endocrinologist opinion where appropriate
complication management ,home hazards , occupational issues , Driving , immunisation
assess CVS risk NAFILD Risk CKD risk