156521 - AJGP Clinical Challenge May 2019: Diabetes
To provide guidance for the general practitioner in the diagnosis and management of diabetes.
Relevance to General Practice
It is estimated that one million Australian adults had type 2 diabetes (T2DM) in 2014–15. Severe hyperglycemia in T2DM can lead to hyperosmolar hyperglycaemic state, which has a mortality rate of up to 20%. The Australian Diabetes Society has released statements indicating that patients with glycated haemoglobin (HbA1c) of 6–6.4% should not be retested for T2DM by either HbA1c or fasting blood glucose (FPG); however, there is evidence that patients with FPG levels consistently greater than 7 mM may still have normal HbA1c levels and would benefit from diet and lifestyle modifications to prevent microvascular complications. Each year, approximately 2500 Australians are diagnosed with type 1 diabetes (T1DM). Although T1DM has historically been managed by finger pricks and multiple injections, new technology – including insulin pumps, which are used by 12% of patients with T1DM – is changing treatment options for patients with T1DM.
References on file.
- Identify new and changing therapeutic options for management of type 1 diabetes.
- Outline the key points to consider when teaching patients with type 2 diabetes to self-administer insulin.
- Discuss the hyperglycaemic states that can occur in patients with type 2 diabetes.
- Describe the correlation between fasting plasma glucose and glycated haemoglobin in the early diagnosis of type 2 diabetes.