Diabetes Mellitus Type 2

3/26/25, 12:36 AM OneNote Diabetes Mellitus Type 2 Wednesday, March 12, 2025 8:57 PM Diabetes Mellitus (T2DM) 1. Professional Communication (1 minute) • Introduction: • "Hello, my name is [Your Name], and I am a student pharmacist. Today, I’ll be discussing Type 2 Diabetes Mellitus." • Professional Dress and Confidence: Maintain eye contact, speak clearly, and dress professionally. • Medical Terminology: Use appropriate medical language throughout the presentation. 2. Background Information (2 minutes) • Introduction: • T2DM is a chronic metabolic disorder characterized by insulin resistance and insulin deficiency, leading to high blood glucose levels. • Epidemiology: • T2DM accounts for 90-95% of all diabetes cases worldwide and is increasingly common due to obesity and sedentary lifestyles. • Classification: • T2DM differs from T1DM (autoimmune) and gestational diabetes (pregnancy-related). • Risk Factors: (3 for full points) • Obesity, family history of diabetes, and sedentary lifestyle. 3. Pathophysiology and Etiology (1 minute) • Pathophysiology: • Insulin resistance develops in peripheral tissues like muscles and the liver, reducing glucose uptake. Over time, pancreatic beta-cell dysfunction worsens insulin deficiency. • Etiology: • Caused by genetic predisposition and environmental factors such as poor diet and lack of exercise. 4. Signs and Symptoms (1 minute) • Symptoms: (3 for full points) • Polyuria (frequent urination), polydipsia (excessive thirst), and polyphagia (excessive hunger). • Diagnostic Criteria: • Fasting glucose ≥ 126 mg/dL, HbA1c ≥ 6.5%, or 2-hour plasma glucose ≥ 200 mg/dL during an OGTT (oral glucose tolerance test) as per ADA Standards of Medical Care in Diabetes 2024. 5. Treatment (2 minutes) • Non-pharmacological Strategies: (2 for full points) https://americancareercollege-my.sharepoint.com/personal/cvo1_u_westcoastuniversity_edu/_layouts/15/Doc.aspx?sourcedoc={5ba16cd8-9933-4504-ade5-0b389535a42c}&action=view&wd=target%28Topic Presentation.… 1/3 3/26/25, 12:36 AM OneNote • Weight loss and regular physical activity. • Pharmacological Approach: (full points: unique clinical pearl for ALL 1st line medication classes/agents) • First-line: Metformin, recommended by the American Diabetes Association (ADA), due to its efficacy and safety. • Clinical Pearl: Metformin: Take with meals to reduce gastrointestinal upset, and monitor renal function regularly. • Second-line: Sulfonylureas (e.g., glipizide), DPP-4 inhibitors (e.g., sitagliptin), SGLT2 inhibitors (e.g., empagliflozin), and GLP-1 agonists (e.g., semaglutide). • Rationale for General Approach: Metformin is preferred as the initial therapy due to its effectiveness, low risk of hypoglycemia, and weight neutrality. It is also associated with cardiovascular benefits, which is crucial given the high cardiovascular risk in diabetic patients. Second-line agents are introduced based on individual patient factors, such as the presence of cardiovascular disease, renal function, and patient preferences regarding side effects and administration routes. For example, SGLT2 inhibitors are particularly beneficial for patients with heart failure or those at risk for renal disease, while GLP-1 agonists are favored for patients needing weight loss. • Duration of Therapy: • Lifelong, but intensity may change depending on glycemic control and complications. Treatment Assessment • Pts who reach treatment goals + maintain stable glycemic control: every 6 months • Pts who DO NOT reach treatment goals: every 3 months Treatment Goals: Population A1C % Pre-prandial (Fasting) Most patients < 7.0 80-130 mg/dL 2-hr PPG < 180 mg/dL Recent ADA Updates • Selecting pharmacotherapy is based on patient-specific factors + treatment goals • De-emphasized metformin as de facto 1st line pharmacologic agent • Selecting agent w/ proven cardiorenal benefit in pts at risk ○ GLP1RA ○ SGLT2i • Glycemic management goals • Weight management goals • ADA 2024 – T2DM w/ HF • SGLT2i or SGLT1/2i (sotagliflozin) w/ proven HF benefit https://americancareercollege-my.sharepoint.com/personal/cvo1_u_westcoastuniversity_edu/_layouts/15/Doc.aspx?sourcedoc={5ba16cd8-9933-4504-ade5-0b389535a42c}&action=view&wd=target%28Topic Presentation.… 2/3 3/26/25, 12:36 AM OneNote 6. Guidelines: • Based on the ADA Standards of Medical Care in Diabetes 2024. 7. Questions (1 minute) • Be prepared to answer questions about specific medications, treatment algorithms, or patient counseling. https://americancareercollege-my.sharepoint.com/personal/cvo1_u_westcoastuniversity_edu/_layouts/15/Doc.aspx?sourcedoc={5ba16cd8-9933-4504-ade5-0b389535a42c}&action=view&wd=target%28Topic Presentation.… 3/3