Microsoft word - diabetes mellitus type 2 doh draft.doc
DIABETES MELLITUS TYPE 2
Lifestyle modification as part of initial management
Measure HbA1c every 3 months depending on
Have lifestyle modifications been successful?
Consider oral hypoglycaemic agents
Is there renal and/or cardiac dysfunction
Consider either metformin or a sulphonylurea
Optimise dose of oral hypoglycaemic agent
If patient on sulphonylurea and has normal
renal function and has no cardiac dysfunction
Consider adding a thiazolidinedione or insulin
• E11 Non-insulin-dependent diabetes mellitus
o E11.0 Non-insulin-dependent diabetes mellitus with coma
o E11.1 Non-insulin-dependent diabetes mellitus with ketoacidosis
o E11.2 Non-insulin-dependent diabetes mellitus with renal
o E11.3 Non-insulin-dependent diabetes mellitus with ophthalmic
o E11.4 Non-insulin-dependent diabetes mellitus with neurological
o E11.5 Non-insulin-dependent diabetes mellitus with peripheral
o E11.6 Non-insulin-dependent diabetes mellitus with other specified
o E11.7 Non-insulin-dependent diabetes mellitus with multiple
o E11.8 Non-insulin-dependent diabetes mellitus with unspecified
o E11.9 Non-insulin-dependent diabetes mellitus without complications
• E12 Malnutrition-related diabetes mellitus
o E12.0 Malnutrition-related diabetes mellitus with coma
o E12.1 Malnutrition-related diabetes mellitus with ketoacidosis
o E12.2 Malnutrition-related diabetes mellitus with renal complications
o E12.3 Malnutrition-related diabetes mellitus with ophthalmic
o E12.4 Malnutrition-related diabetes mellitus with neurological
o E12.5 Malnutrition-related diabetes mellitus with peripheral circulatory
o E12.6 Malnutrition-related diabetes mellitus with other specified
o E12.7 Malnutrition-related diabetes mellitus with multiple complications
o E12.8 Malnutrition-related diabetes mellitus with unspecified
o E12.9 Malnutrition-related diabetes mellitus without complications
o O24.1 Pre-existing diabetes mellitus, non-insulin-dependent
o O24.2 Pre-existing malnutrition-related diabetes mellitus
o O24.3 Pre-existing diabetes mellitus, unspecified
1. Medical management reasonably necessary for the delivery of treatment described in this algorithm is included within this benefit, subject to the application of managed health care interventions by the relevant medical scheme. 2. To the extent that a medical scheme applies managed health care interventions in respect of this benefit, for example clinical protocols for diagnostic procedures or medical management, such interventions must – a. not be inconsistent with this algorithm; b. be developed on the basis of evidence-based medicine, taking into account considerations of cost-effectiveness and affordability; and c. comply with all other applicable regulations made in terms of the Medical Schemes Act, 131 of 1998 This algorithm may not necessarily always be clinically appropriate for the treatment of children. If this is the case, alternative paediatric clinical management is included within this benefit if it is supported by evidence- based medicine, taking into account considerations of cost-effectiveness and affordability.
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