PBL 5 session 3

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PBL 5 session 3 by Mind Map: PBL 5 session 3

1. Step 9

1.1. Review session 2

1.2. mechanism flow chart

1.3. 20 minutes

2. Step 10

2.1. Management

2.1.1. goals quality of life lifestyle modification reducing symptoms and prevent complications education regarding therapy

2.1.2. non-pharmacological diet low GI diet, high fibre and low saturated fat can rarely be enough referral to dietitian educate how to monitor meal portions monitor salt intake for hypertention calorie intake exercise 150 minutes per week of physical activity active muscles increase uptake of glucose from blood thus decreasing insulin resistance cardiac assessment in select patients surgery bariatric surgery specific inclution and excluttion criteria liposuction psychological assesmernt education for patient and family

2.1.3. pharmacological HbA1c less than 7 medication groups decrease insulin ressistance decrease glucose absorbtion from GI decrease gluconeogenisis in liver sulfonurias reduces insulin resistance and increase insulin release from beta cells and decrease glucose production from liver weight gain and hypoglycemia metformin first line low cost and does not cause hypoglycemia and is weight neutral decrease glucose uptake from gut GI symptoms most prominent good effect on LDL rare side effect is lactic acidosis TZD increase risk of heart failure, anemia and edema increase insulin sensitivity causes weight gain and hepatotoxicity expensive DPP4 inhitors new med and not available everywhere can reduce weight by working on satiety insulin several modalities HbA1c over 10 indication for first line therapy blood pressure control ACE inhibitors should be 140/90 or less lipids LDL less than 2.6 triglycerides less than 1.7 HDL more thn 1 statins weight loss orlistat OSA CPAP? sleeping on side

2.2. Prevention

2.2.1. primary environmental factors lifestyle public education

2.2.2. secondary public campaigns screening test treatment compliance

2.2.3. tertiary screening for micro and macro vascular complications

2.3. 60 minutes

3. step 11

3.1. Review and evaluate

3.2. Group members

3.3. Chairman

3.4. Scribe

3.5. Tutor

3.6. Material

3.7. 10 minutes