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  Diabetes Medication Therapy Adherence Clinic (DMTAC)
MOH CPD Category A8: 5 points
1 APRIL 2017

List of authors:

  • Albert Ting Siong Hung
  • Ching Min Wei
  • Malathi a/p Sriraman @ Jayaraman
  • Navin Kumar a/l Loganadan

This module consists of five chapters on diabetes mellitus, its managements and complications, for the management of a Diabetes Medication Therapy Adherence Clinic (DMTAC).

Chapter 1 discusses the prevalence of diabetes in Malaysia and the impact of reducing glycated haemoglobin (HbA1c) on complications of diabetes. This chapter describes the DMTAC services and its protocol in Malaysia, including the forms used in documentation of this DMTAC.

Chapter 2 summarises the latest Clinical Practice Guidelines (CGP) 2015 for the management of type 2 diabetes mellitus (T2DM). This chapter includes algorithms for the management of T2DM in different conditions and the types of patients.

Chapter 3 covers the various classes of oral antidiabetes agents, including the mechanisms of action, formulations and dosages, methods of administration, adverse reactions and contraindications.

Chapter 4 describes the types of insulin available either in government or private health institutions in Malaysia. This guide is meant for all healthcare professionals especially pharmacists involve in the management of patients with type 2 diabetes mellitus. It covers insulin regimens, initiation, optimisation and intensification, which serves as a guide during the DMTAC sessions.

Chapter 5 includes the prevalence of diabetes and its classifications. The classifications of diabetes cover the pathophysiology, risk factors, diagnosis, signs and symptoms, goals of treatment and complications. Complications of diabetes are described in details.


CONTENTS OF MODULE

CHAPTER 1: INTRODUCTION TO DIABETES MEDICATION THERAPY ADHERENCE CLINIC (DMTAC)

1.1 STATUS OF DIABETES IN MALAYSIA IN THE PAST 20 YEARS
1.2 ADHERENCE STATUS OF DIABETES PATIENTS
1.3 IMPACT OF REDUCING HBA1C IN DIABETES COMPLICATIONS
1.4 WHAT IS MEDICATION THERAPY ADHERENCE CLINIC (MTAC)?
1.5 OBJECTIVES OF DIABETES MTAC (DMTAC)
1.6 BENEFIT OF PHARMACIST LEAD DIABETES CLINIC
1.7 DMTAC IN MALAYSIA
1.8 SCOPE OF DIABETES MTAC
1.9 PATIENT SELECTION
1.10 WORKFLOW OF DMTAC DURING FIRST VISIT
1.11 WORKFLOW OF DMTAC FOR SUBSEQUENT FOLLOW-UP VISITS
1.12 DMTAC FORMS AND TOOLS
1.13 DISCHARGE CRITERIA
1.14 SUCCESSFUL STORIES OF DMTAC IN MALAYSIA

CHAPTER 2: OVERVIEW OF CLINICAL PRACTICE GUIDELINES: MANAGEMENT OF TYPE 2 DIABETES MELLITUS (T2DM) 2015

2.1 SCREENING AND DIAGNOSIS OF T2DM
2.2 MANAGEMENT OF TYPE 2 DIABETES MELLITUS
2.3 MANAGEMENT OF DIABETES EMERGENCIES
2.4 MANAGEMENT OF CHRONIC COMPLICATIONS
2.5 DIABETES IN SPECIAL POPULATIONS
2.6 PREVENTION OF T2DM

CHAPTER 3 : PHARMACOTHERAPY OF ORAL ANTIDIABETES AGENTS

3.1 CLASSES OF ORAL ANTIDIABETES AGENTS

  1. BIGUANIDES
  2. SULPHONYLUREAS (SUS)
  3. MEGLITINIDES
  4. THIAZOLIDINEDIONES (TZDS)
  5. ALPHA-GLUCOSIDASE INHIBITORS (AGIS)
  6. DIPEPTIDYL PEPTIDASE-4 (DPP-4) INHIBITORS
  7. SODIUM-GLUCOSE CO-TRANSPORTER- 2 (SGLT-2) INHIBITORS

3.2 NON-ORAL/NON- INSULIN PHARMACOTHERAPY

  1. INCRETIN MIMETICS : GLUCAGON-LIKE PEPTIDE-1 (GLP-1) RECEPTOR AGONISTS

CHAPTER 4: INSULIN THERAPY IN TYPE 2 DIABETES MELLITUS

4.1 INTRODUCTION
4.2 INSULIN PREPARATIONS
4.3 ANALOG INSULIN 4.4 INSULIN REGIMEN
4.5 INSULIN INITIATION, OPTIMISATION AND INTENSIFICATION
4.5.1 Insulin Initiation
4.6 INSULIN INTENSIFICATION
4.7 INSULIN SIDE EFFECT
4.8 GENERAL GUIDELINES FOR LONG TERM USE OF INSULIN
4.9 INSULIN PUMP

CHAPTER 5.0 DIABETES AND CO-MORBID DISEASES

5.1 INTRODUCTION
5.2 CLASSIFICATIONS OF DIABETES

 

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