Dr. Mohamed Al-Shekhani.

Pathophysiology of DM.

Dual Metabolic Abnormalities in T2DM

Excessive Hepatic Glucose Output

Decreased Glucose Uptake

Insulin DeficiencyInsulin Resistance

Decreased Insulin Secretion

Unrestrained Lipolysis

Treatment:

• Diet/Exercise: both types• TIDM: Insulin.• T2DM: Oral hypoglycemic drugs +/- insulin.

Stepwise Management of T2 DM

Insulin ± oral agents

Oral combination

Oral monotherapy

Diet & exercise

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