New onset diabetes mellitus

Treatment

• If HbA1c > 6.5, titrate fasting blood sugar to 80 to 120
• ADA diet control until HbA1c is >7
• 1st line Metformin 500mg BID --> 1000mg BID, do not give in people with abnormal LFT's, CHF Stage 3/4 and ARI, CKD
• 2nd Agent Glipizide start 2.5mg BID -->5mg BID, need to monitor for hypoglycemia
• 3rd Agent Pioglitazone
• After 3 agents need to start insulin if not controlled, ie NPH BID or Lantus Qday (0.5mg/kg) and titrate to Fasting Blood Sugar
• all DM need HbA1c q 3mo, Ma-cr to check for microalbuminuria q year

See Also

• Diabetes Mellitus (Main)