Type of Diabetes.....
Type 1 diabetes
Type 2 diabetes
Others Type of
Diabetes....
Gestational diabetes
Pre-diabetes
Diagnosing
Diabetes....
Classical symtoms : 6P
Fasting Blood Glucose (FBG):
126 mg/dl
Post prandial Blood Glucose :
200 mg/dl
Oral Glucose Tolerance Test (OGTT)
Blood glucose level is measured
fasting and two hours after drinking a
glucose-rich beverage (75 gr) Blood
Glucose 200 mg/dl
Komplikasi dari
diabetes....
Obat-obatan
Diabetes...
Tahapan terapi...
ADA/EASD: Metabolic
Management of Type
2 Diabetes
Which Insulin ?
Basal insulins
U/
ml
80
60
Normal pattern
40
20
0600
0800
1200
1800
2400
0600
Time of day
B = breakfast; L = lunch; D = dinner
Riddle MC. CADRE Core Slide Kit. 2003
Polonsky KS et al. N Engl J Med. 1988;318:1231-1239
Approximate pharmacokinetic
profiles of human insulin and
insulin analogues
N.B. Duration of action will vary widely between and within people
NPH = neutal protamine hagedorn/isophane insulin
Fasting Hyperglycemia
Basal Insulin
Prandial Hyperglycemia
Prandial Insulin
Prandrial
Basal
Algoritma
penggunaan insulin....
Hypoglycemia
or FG >3.89 mmol/l (70 mg/dl):
Reduce bedtime dose by 4 units
(or 10% if dose >60 units)
If HbA1c 7%...
Continue regimen;
check HbA1c every 3
months
3.89-7.22 mmol/L
(70-130 mg/dL)
If HbA1c 7%...
If HbA1c 7%...
Continue regimen; check
HbA1c every 3 months
Target range:
If HbA1c 7%...
Recheck pre-meal BG levels and if out of range, may need to add another
injection; if HbA1c continues to be out of range, check 2-hr postprandial
levels and adjust preprandial rapid-acting insulin
Nathan DM et al. Diabetes Care. 2006;29(8):1963-72.
Perbedaan antara
Hiperglikemia dengan
Hipoglycemia....
Supplemental Regular
Insuline Scale
Pre Prandial Glucose
(mg/dl)
< 100
100 140
140 160
160 180
180 200
200 250
250 300
> 300
0
2
3
4
5
6
8
10
Terima kasih.....
Semoga bermanfaat untuk kalian semua.....
Keep in touch yach.......