Chak Angre Health Center

គ្រូ​ពេទ្យ​យាម​ប្រចាំ​ការ​២៤ម៉ោង​
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យាម​ប្រចាំ​ការ​24ម៉ោង​ 12-08-2025

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Type 2 Diabetes management
Treatment
The first step in managing Type 2 is to initiate treatment with . If necessary, SGLT2i can be added, particularly for patients with chronic heart failure or established disease (CVD) and a high QRISK score (>10%).

Treatments
If Metformin is or not , alternative treatments can be considered, including DPP4i, , SU, and SGLT2i.


If monotherapy is not effective, combination therapy can be initiated. The preferred combinations include:
- Metformin + DPP4i, Pioglitazone, or
- Metformin + SGLT2i + DPP4i, Pioglitazone, or Sulfonylurea (triple therapy)


The treatment preferences based on specific characteristics, such as:
- CVD/HF/High Risk CVD/CKD: SGLT2i
- Weight concerns: GLP-1
- : SU

# # Triple Not Effective
If triple therapy is not effective, consider switching one out for a GLP-1 receptor agonist, particularly for patients with a BMI >35 or those who would benefit from weight loss.


Insulin therapy can be initiated when necessary, with options including:
- Insulin (OD or BD) as first-line treatment
- Isophane + Short Acting (Mixed) if >75mmol/mol
- Detemir/Glargine if assistance is needed (carers)

Targets
The HbA1c targets for different patient groups, including:
- Diet: 48mmol/mol
- Metformin/Single drug not associated with hypos: 48mmol/mol
- Drug treatment associated with hypos: 53mmol/mol
- Step up in treatment when HbA1c: 58mmol/mol

Risk Reduction
The guidance on CVD risk reduction, including:
- QRISK >10%: Atorvastatin 20mg
- (No CKD):

សកម្មភាព​ការ​ពិនិត្យ​ ព្យាបាល​ ជំងឺ​ភ្នែក​និង​ចែក​ជូន​វ៉ែនតា​ នៅ​មណ្ឌល​សុខភាព​ចាក់​អង្រែ

សូម​ជំរាប​ជូន​ប្រជាពលរដ្ឋ​ឲ្យ​បាន​ជ្រាប​ថា​នៅ​ថ្ងៃ​សុក្រ​ទី​២១​ ខែ​មិនា​ ឆ្នាំ​២០២៥​ នេះ​មាន​កម្មវិធី​សុខភាព​ភ្នែក​ ពិនិត្យ​និង​ព្យាបាល​ជំងឺ​ភ្នែក​និង​មាន​ចែក​ជូន​វ៉ែនតា​ដោយ​ឥតគិតថ្លៃ​ចាប់​ពី​ម៉ោង​៨:០០​ព្រឹក​តទៅ​ ទីតាំង​នៅ​ មណ្ឌល​សុខភាព​ចាក់​អង្រែ​ សង្កាត់​ចាក់អង្រែ​ ក្រោម​
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