Criteria for diabetes medicine prescription

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Sorry for your experience Dr Abdul Majeed on behalf of our doctors fraternity. All doctors are not bad , very few people will behave like that. Criteria for treatment of patients with Diabetes depends on somany factors. 1) Proper diagnosis of the case. Type of DM whether it is Type 1 DM or Type 2 DM or GDM or Secondary Diabetes. 2) Duration of diabetes and insulin secretion from betacells of pancreas and insulin resistance. 3) Exclude Diabetic emergencies like DKA, HHS, etc. 4) There are no hard and fast rules in the treatment. Methodical approach is necessary for control of blood sugars. 5) In Type 1 DM the drug of choice is only insulin for life time. 6) In GDM ( Gestational Diabetes mellitus) also, insulin is the only approved drug to treat Diabetes. 7) In secondary DM due to various causes e.g Chronic pancreatitis Pancreatic cancer Drug induced Diabetes like Steroids Anti hypertensive drugs like Atenolol Diuretics Antipsychotic drugs Retroviral drugs Statins ,etc. In such cases insulin is the only option. 8) The most common of all is Type 2 DM there are various modalities of treatment. Selection of Patient is important to initiate the antidiabetic drugs. 1) In obese or overweight , non obese Type 2 DM,the drug to start is Metformin along with LSM and TLC unless there are contraindications such as DKA Acute liver failure CCF Myocardial infarction GI intolerance DKD . Most of the cases require more than one OHA. .There are so many drugs like 2) Sulfonylureas like Glimipiride, Glipizide, Gliclazide, Glibenclamide etc 3) Alfa glucosidase inhibitors like voglibose, acarbose etc 4) Thiozolidinidiones like Pioglitazone 5) Non sulfonylureas like meglitinide, repaglinide etc . 6)DPP4 Inhibitors like Sitagliptin Linagliptin Vildagliptin Saxagliptin Alogliptin etc 7) SGLT2 Inhibitors like Empagliflozin DAPAGLIFLOZIN Canagliflozin Ertugliflozin Remogliflozin etc 8) GLP1 agonist s like Liraglutide Exenatide Semaglutide Dulaglutide etc 9) Human insulins like Regular insulin like Actrapid etc Basal Insulin is NPH , Insulatard etc Premixed biphasic human insulin like Human mixtard etc Novel analogue insulins like Novorapid/ Fiasp( Aspart) Novomix ( soluble Aspart and protamine crystalline aspart in 30: 70 ratio) Ryzodeg is Basal plus contains 30 % of soluble aspart and Degludec 70% Basal analogue insulins are Glargine Detemir Degludec Latest basal Insulin under phase 3 trial is Icodec . Prescription varies from person to person depending on so many factors , giving gist is very difficult .
I agree Mam with you

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The diabetologists don't have any valid explanation for precribing a particular drug to lower blood sugar. One gives metformin the other gives linaglyptin a third dr gives insulin. If you ask him the reason he gets irritated. He is more interested in his pp not the pt.There are very few who follow the ethics. I am myself a diabetic. This is my experience. Please excuse me if I am hurting any one
You asked about criteria for treatment of diabetes Nothing only one target to keep blood sugar in range as strictly as possible Either by insulins or oral antihyperglycemics There is advise for diet restrictions and exercise Change in lifestyle Yes there are protocols in different kind of diabetes with modalities Also considering age sex and stage or complications
Thanx dr Mittakola Praveen

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Tnx Dr Manoj Kumar

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Metformin (Glucophage, Glumetza, others). Generally, metformin is the first medication prescribed for type 2 diabetes. It works by lowering glucose production in the liver and improving your body's sensitivity to insulin so that your body uses insulin more effectively.
DM a complete care not only blood glucose control.basing on age.wt.and comorbid state drug Rx differs
Thanks ma'm for explaining in detail.
Most welcome sir

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