FARMAKOTERAPI DIABETES MELITUS (DM): Guideline/Tatalaksana DM Tipe 2

Summary

This video provides an informative guide on managing diabetes, covering insulin usage, medication, and non-pharmacological interventions. It explains how insulin and other drugs like sulfonylureas can lead to hypoglycemia and outlines treatment options. The video also highlights the importance of balanced nutrition, regular physical activity, and proper foot care for diabetic patients. Weight management, smoking cessation, and understanding the side effects of medications such as Metformin and Acarbose are emphasized. Overall, it offers practical advice for patients to manage their condition effectively and prevent complications.

Takeaways

• 😀 Insulin dosage is determined based on whether the patient has fasting hyperglycemia or prandial hyperglycemia, requiring careful monitoring of blood glucose levels.
• 😀 Hypoglycemia is a common side effect of insulin usage and certain oral antidiabetic medications like sulfonylureas, which can lower blood glucose levels below 70 mg/dL.
• 😀 Mild hypoglycemia can be treated by giving the patient 2-3 tablespoons of sugar dissolved in water, followed by checking blood glucose after 15 minutes.
• 😀 Severe hypoglycemia, marked by symptoms like blurred vision and extreme weakness, requires intravenous dextrose (10% solution) or an injection of glucagon.
• 😀 Medications like Metformin may cause gastrointestinal discomfort, so it should be taken with meals to minimize side effects.
• 😀 Acarbose, an antidiabetic drug, should be taken with the first bite of a meal to effectively block carbohydrate breakdown and reduce glucose absorption.
• 😀 Sulfonylureas have a long half-life and are typically taken once daily, often during breakfast, as they can cause prolonged hypoglycemia.
• 😀 Non-pharmacological interventions like managing diet, regular exercise (150 minutes per week), and proper foot care play an essential role in diabetes management.
• 😀 Foot care is crucial for diabetic patients to avoid unnoticed wounds, as diabetes can impair healing and make the feet prone to infections.
• 😀 Weight management is critical for diabetic patients, with a goal of reducing body weight by 5-10% over six months to improve glucose control.
• 😀 Quitting smoking is highly recommended for diabetic patients as smoking increases oxidative stress, which can worsen diabetes-related complications.

Q & A

What are the two main types of hyperglycemia that insulin usage is adjusted for?

Insulin usage is adjusted for two types of hyperglycemia: fasting hyperglycemia and post-prandial (after meal) hyperglycemia.

What are the common symptoms of hypoglycemia caused by insulin or sulfonylurea usage?

Common symptoms of hypoglycemia include weakness, fatigue, rapid heartbeat (tachycardia), and, in severe cases, blurred vision and confusion.

How can hypoglycemia be treated if the patient is conscious?

If the patient is conscious, hypoglycemia can be treated by giving 2-3 teaspoons of sugar dissolved in water, followed by a check of blood glucose levels after 15 minutes.

What should be done if a patient experiences severe neuroglycopenic symptoms due to hypoglycemia?

If a patient experiences severe neuroglycopenic symptoms, they should be taken to the hospital immediately for an infusion of 10% dextrose (150 ml) or 40% dextrose (25 ml) over 15 minutes. Blood glucose should be checked 15-30 minutes after the infusion.

How does insulin interact with glucagon in regulating blood glucose levels?

Insulin and glucagon work together to regulate blood glucose levels. Insulin lowers blood sugar by promoting glucose uptake into cells, while glucagon increases blood sugar by signaling the liver to release glucose.

What side effects are commonly associated with Metformin?

Metformin is commonly associated with gastrointestinal side effects, such as discomfort or nausea. To reduce these effects, it is advised to take Metformin with meals.

Why must Acarbose be taken with the first bite of food?

Acarbose should be taken with the first bite of food because it inhibits the enzyme responsible for breaking down carbohydrates into simpler sugars, which prevents a spike in blood glucose.

What is the primary reason for prescribing sulfonylureas once a day?

Sulfonylureas are prescribed once a day due to their long half-life, which allows for effective blood sugar control throughout the day with a single dose.

What are the recommended guidelines for physical activity in diabetes management?

The recommended guidelines for physical activity are 30-40 minutes of moderate exercise, 3-5 times per week, totaling 150 minutes per week.

What role does weight management play in diabetes management, and what is the target weight loss?

Weight management is crucial in diabetes management because obesity is a major risk factor for diabetes. A target weight loss of 5-10% over six months is often recommended as an indicator of successful management.