Friday, December 7, 2012

Health is Gold


Today I'm going to do a summary of what I learnt during the 2 days conference last weekend. It was an Ambulatory Care HKL Pharmacy Conference. So, here are the facts and figure:

  • Medication Therapy Adherence Clinic (MTAC) is also known as Medication Therapy Management (MTM) in USA
  • Diabetes in Malaysia 2011: has increase to 20.8% from 14.9% previously.
  • 1 of 5 adult Malaysians above 30 years old have diabetes. 
  • 366 million people with diabetes in year 2011.
  • 28% Asians with uncontrolled type 2 diabetes (HbA1c >7%) on OAD & insulin therapy.
  • 9.9% world population expected to have diabetes in 2030.
  • 130 billion USD spent on diabetes in European region in 2011.
  • 44% American with diabetes not at HbA1c target.
  • 22% Malaysian with diabetes reaxhed HbA1c target.
  • A1c = fasting glucose + postprandial glucose.
  • Higher than 10 A1c, preblem is fasting plasma glucose.
  • Lower than 10 A1c problem is post prandial glucose.
  • A reduction of 1% HbA1c may reduce 37% of macrovascular complication in diabetes patient.
  • Immediate use of insulin may improve glycemic control and lower risk of complications.
  • Hypoglycemia in diabetes patients can cause heart attack.
  • Insulin is meal related.
  • Incretin is an intestine secretion insulin (gut derived factor).
  • Pancrease; alpha cells reduces hepatic glucose production & beta cells: increase glucose uptake by peripheral tissue.
  • Alpha blocker may cause postural hypotension.
  • Aspirin can be given as a stroke preventive medication.
  • 50% of kidney damage for the creatinine level to rise.
  • Tighter Blood Pressure control is more important compared to glycemic control to reduce mortality (death).
  • Hypertension treatment reduces cardiovascular events in diabetes.
  • Diabetic BP: less than 130/80
  • Poor BP control may lead to TIA & stroke.
  • Q10 reduces muscle cramps.
  • To start anticoagulation meds, use CHADS risk criteria; higher CHADS score, higher chance of stroke.
  • Bleeding comparison; warfarin is better than aspirin.
  • For asthma treatment, Step down if 3 months without attack; well controlled.
  • COPD classification uses CAT (COPD assessment test) score.

An apple a day keeps the doctor away.
Take care of your health as it is very precious for oneself.

Wassalam & Cheers.

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