Review Article
Diabetes Mellitus type 2: Management and follow up in
Primary Health Care Center, Review Article
Ashraf Ali AlKinani1, Ibrahim Mohammed Alkhrizi1, Saleh Hamdan Alkathiri1, Hani Lahk A Alzubaidi1, Abdulrahman Ahmed
Alghanmi1, Abdulrahman Mohammed Alghanmi1, Ibrahim Ahmed Alnashri1, Alruwaili Amal Muhaysin B2, Abdulrahman mohammad
Alahmadi3, Zainab Ali Alaithan4
1
Faculty of Medicine, Alqunfudah Medical College, Alqunfudah, KSA. 2Faculty of Medicine, Northern Border University, Arar, KSA.3Intern,
Faculty of medicine, Taibah University, KSA. 4Intern, Faculty of Medicine, King Faisal University, Al Ahsa, KSA.
Abstract
Diabetes mellitus is a worldwide epidemic, affecting around half a billion patients and these numbers are expected to grow within the next
few years and decades, Placing a huge burden on the health system worldwide, this is because the chronic hyperglycemic state is associated
with multiple long-term complications including micro and macrovascular complications in addition patients may develop acute
complications such as Diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state, and hypoglycemia, which all may lead to fatal
consequences. Our objective was to look into the literature concerning diabetes management and follow-up in particular type 2 PubMed
database was used for articles selection, papers were obtained and reviewed. Management of diabetic patients should be individualized but
the main principles of care are to achieve adequate glycemic control, through lifestyle modifications, pharmacological and surgical
management, in addition to early identification and modification of cardiovascular risk factors that could contribute to developing
atherosclerotic diseases one of the main causes of mortality, in addition to establishing scheduled follow-up appointments to screen for
complication through physical examination, history taking and laboratory test.
Keywords: Diabetes mellitus, DM, Management, Follow up, Primary health care
INTRODUCTION
Diabetes mellitus is a group of metabolic diseases that causes
affected individuals to have hyperglycemia, this happens due
to either a defect in insulin secretion, insulin action, or both
[1]. diabetes has become a worldwide epidemic, with
astronomical numbers of estimated cases, where type 2
diabetes is responsible for up to 425 million patients, and a
death toll of 4 million in 2017 [2], while type 1 diabetes
accounts for approximate 9 million affected individuals [3].
And these numbers are only expected to increase by 25% in
2030 and 51% in 2045 [4]. Placing a huge burden on the
health system worldwide, especially that Chronic
hyperglycemic state can have devastating effects on the
human body and are associated with long-term damage and
dysfunction, in particular retinopathies, nephropathies,
neuropathies, and vascular complications [5], in addition,
patients may develop acute complications such as Diabetic
ketoacidosis (DKA), hyperglycemic hyperosmolar state, and
hypoglycemia, which all may lead to fatal consequences [6].
In this review, we will go discuss the management and
follow-up for diabetic patients in particularly type 2 diabetes.
MATERIALS AND METHODS
PubMed database was used for articles selection, and the
following keys used in the mesh ((diabetes) OR (diabetic))
AND (management)) OR (follow-up)). In regards to the
© 2021 Archives of Pharmacy Practice 1
inclusion criteria, the articles were selected based on the
inclusion of one of the following topics; diabetes,
management, and follow-up. Exclusion criteria were all other
articles that did not have one of these topics as their primary
endpoint.
Review
Management approach to patients with diabetes has multiple
aspects and should be tailored based on individual needs and
patients-factors [7], but we will try to summarize and present
the general recommendations based on the latest evidence.
We can classify the management into 3 broad categories
which are glycemic control, prevention of complications, and
Address for correspondence: Alruwaili Amal Muhaysin B,
Faculty of Medicine, Northern Border University, Arar, KSA.
amaal998@outlook.sa
This is an open-access article distributed under the terms of the Creative Commons
Attribution-Non Commercial-Share Alike 3.0 License, which allows others to remix,
tweak, and build upon the work non commercially, as long as the author is credited
and the new creations are licensed under the identical terms.
How to cite this article: AlKinani A A, Alkhrizi I M, Alkathiri S H,
Alzubaidi H L A, Alghanmi A A, Alghanmi A M, et al. Diabetes
Mellitus type 2: Management and follow up in Primary Health Care
Center.
Arch.
Pharm.
Pract.
2021;12(4):4953. https://doi.org/10.51847/mVmt9SdIfp
49
AlKinani et al.: Diabetes Mellitus type 2: Management and follow up in Primary Health Care Center, Review Article
management of short- and long-term complications, we will
focus in our discussion on the former two.
Glycemic Control
The cornerstone of management in diabetic patients is proper
glycemic control, as data from numerous research have found
that the incidence of diabetic complications is directly related
to poor glycemic control [8]. Latest recommendations
advocate for using glycated hemoglobin (A1C) for glycemic
assessment as it is considered a reliable measure of chronic
hyperglycemia and a good predictor for long-term diabetes
complications [9]. The target goal of glycated hemoglobin
level should be individualized, balancing the health benefit
on one hand and adverse effects such as hypoglycemic attacks
and additional expenses on the other hand. But in general,
most young patients without any established complications
the recommended goal is
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