Treatment for DM type 2

1. Education
2. Medical Nutrition Therapy
- Carbohydrates: 45-65% of total energy intake is recommended
- Fat: recommended <200 mg / day (20-25% of total energy intake)
Saturated fat: <7%
Weak polyunsaturation: <10%
-Protein: 0.8 g / KgBB recommended (10-20% total energy intake)
-Sodium: recommended <2300 mg / day
- Fiber: recommended 20 - 35 gr / day.
3. Physical Exercise
4. Pharmacological therapy
 4. Pharmacological therapy
Pharmacological therapy consists of oral medications and injections.
A. Oral hypoglycemic drugs (OHO)
Based on the way it works, OHO is divided into 5 groups:
1. Triggers of insulin secretion (insulin secretagogue): sulfonylureas and
glinids
2. Increased sensitivity to insulin: metformin and thiazolidindion
3. Inhibitors of gluconeogenesis (metformin).
4. Glucose absorption inhibitors: alpha glucosidase inhibitors
5. DPP IV inhibitors
B. Injections
- Insulin
Includes injectable anti-hyperglycemia, namely insulin, GLP-1
agonists and a combination of insulin and GLP-1 agonists
Based on the length of work, insulin is divided into 5 types, namely:
fast working insulin (Rapid-acting insulin), short-acting insulin
(Short-acting insulin), medium-acting insulin (Intermediateacting
insulin), long-acting insulin (Long-acting insulin), Ultra long
working insulin (Ultra longacting insulin).
- GLP-1 agonist
Treatment based on GLP-1 enhancement is a new approach to the
treatment of DM
Treatment for Neuropathy
• In peripheral neuropathy, loss of distal sensation is an important factor
at high risk for foot ulcers which increases the risk of amputation.
• Symptoms that are often felt in the form of legs feel burning and
vibrating on their own, and feel more painful at night
• After the diagnosis of T2DM is established, skrinning is needed for
each patient to detect symmetrical distal polyneuropathy by performing
a simple neurological examination (using monofilament 10 grams).
This check is then repeated at least every year.
• In the state of distal polyneuropathy, adequate foot care is needed to
reduce the risk of ulceration and amputation
• Tricyclic antidepressant therapy, gabapentin or pregabalin can reduce
pain.
• All people with DM accompanied by peripheral neuropathy should be
provided with foot care education to reduce the risk of foot ulcers.