23/11/2025
CADET 2025
1. Cardio metabolic condition in Type 2 Diabetes must be managed and controlled
2. Comprehensive for management Type 2DM is ABC (A1C, Blood Pressure, Cholesterol)
3. Four medication useful in CKD and Diabetes
RAS + SGLT2i + nsMRA + GLP1
4. Multidisciplinary team for CKD severe stage
5. GLP1 useful for Cardio renal metabolic, obesity and reduce weight safety
6. GLP1 Injection once per week available in Cambodia (Semaglutide 0.25mg, 0.5mg, 1mg)
7. Treatment diabetes focus on patient not the disease (Social economic, affordable, available. condition, religion, life expectancy…Etc)
8. ASCVD score is very useful for Diabetes individual
9. Continuous Glucose Monitoring (CGM) is very useful for evaluation glycemic on the patient and accuracy.
10. CGM is modern technology for follow up and evaluation glycemic in Diabetes Individual
11. Medical application in Khmer Language for education, appointment Dr. and guidance patient is CarnetDia
12. Primary prevention CVD is necessary, Modern Statin (Atorvastatin or Rosuvastatin) benefit for Cardiovascular problem
13. Anti-Lipid for primary or secondary prevention CVD risk is
Atorvastatin
Rosuvastatin
Rosuvastatin + Ezetimibe
14. Diagnosed Metabolic syndrome in young adults 20-39years with high or extreme ASCVD risk, High Intensity Statin is recommended
Atorvastatin 40-80mg
Rosuvastatin 20-40mg
Rosuvastatin + Ezetimibe 10/10, 10/20
GOAL:
Cholesterol LDL < 70mg/Dl (Primary prevention)
Cholesterol LDL < 40mg/Dl (Secondary prevention)
After achievement Lipid in target, convert to low intensity statin for maintain dose
15. GLP-1 is modern drug for Cardio renal metabolic, diabetes and weight reduction but long term use and expensive, Every prescription need to clarify and explain family and patient
16. Obesity is disease need to managed before complication # Early managed Early Prevention
17. Parameter for Evaluation Kidney dysfunction in T2DM including Creatinine/eGFR, Proteinuria, ACR, Cystatin C test (Very useful and accurate)
18. Gene AI is very useful for medical field (Chat GPT, Deepseek, Gemini….Etc)
19. Every pregnancy need to do test for finding Diabetes, OGTT is very useful and accuracy test for confirm GDM and Pre-GDM
20. OGTT result confirm GDM
T0: Fasting BG > 92mg/Dl
T60: BG > 180mg/Dl
T120: BG between 150-199mg/Dl
21. Criteria for GDM and Pre-Exiting DM in Pregnancy Individual
22. Complication of GDM to Maternal and Fetal
23. Glycemic Target on GDM and Pre-Exiting DM in Pregnancy Individual
- Pre Prandial Glucose ≤ 95mg/Dl
- 1h PPG ≤ 140mg/Dl
- 2g PPG ≤ 120mg/Dl
24. Insulin use in GDM (Basal, Intermediate, Regular Insulin)
25. Metformin is safety in GDM (FDA Category B.)
26. Insulin Pump Available in Cambodia 🇰🇭 (Calmette Hospital or Private Health Sector)
27. Useful of CGM in Gestational DM or Pre-Exiting DM
28. Work shop of CGM
29. CCB friendly in CKD condition
30. G/A and Experiences from Professor, Senior Medicine and Colleges
November 23, 2025
Dr. Pyramid
