3.4.1 Epidemiology of Diabetes

Question 1

How many people in the world are estimated to have diabetes?

Answer 1

9% of all adults >18yo

Question 2

When is screening recommended for diabetes?

Answer 2

Screening is routinely recommended for men and women with a BMI of 25 or higher.

Question 3

What point on this graph is perfectly sensitivity?

Answer 3

B

Question 4

High sensitivity and a negative result will do what?

Answer 4

SNOUT

High sensitivity will and a negative result will rule out disease

Question 5

What is a negative likelihood ratio? (1, <1,<.1)

Answer 5

LR-:

1: test has no discriminatory value

< 1 - Persons without disease more likely to yield a negative test than a person with disease

<.1 - Test has high diagnostic value

Question 6

What is sensitivity?

Answer 6

The ability of a test to correctly identify who has a disease

Question 7

Is the oral glucose tolerance test good?

Answer 7

Most sensitive test

Likelihood ratio is 9.46

Question 8

What is pretest probability?

Answer 8

Probability of a disease before a test is done

Question 9

What are the risk factors associated with Type 1 diabetes?

Answer 9

Autoimmune, genetic and environmental

Question 10

What is prediabetes?

Answer 10

Question 11

What point on this graph is perfect specificity?

Answer 11

E

Question 12

How is the age adjusted prevalance of diabetes among adults in 2014?

Answer 12

Question 13

What is the prevalance of diabetes among the US population?

Answer 13

9. 3%
10. 1m people

28% undiagnosed

Question 14

How would test performance change if the cutoff for a test was 140 instead of 126?

Answer 14

The test would have a lower sensitivity and increase the specificity

Question 15

Compare the Sensitivity, Convenience, Cost, and Associated risks of the glucose tolerance test, A1c, and FPG.

Answer 15

Question 16

When choosing a cutoff point for a test what are the import considerations?

Answer 16

Question 17

How does percentage of people with diabetes change with age?

Answer 17

Increases with age

20-44 : 4.1%

45 - 64 : 16.2%

>64 : 21.8%

Question 18

What is the specificity of a test?

Answer 18

The ability of a test to identify those who do not have disease.

Question 19

How is obesity distributed through the United States?

Answer 19

Question 20

What is SPIN?

Answer 20

Question 21

What is diabetes mellitus?

Answer 21

Disease where blood glucose levels are elevated

Cause - Insufficient insulin or insulin resistance

Question 22

How can you use a pretest probability and likelihood ratio to get a posttest probability?

Answer 22

Using a normogram.

Take the pretest probability and use the likelihood ratio to find the post test.

Question 23

How does a prior history of gestational diabetes affect a patients risk of having diabetes?

Answer 23

Risk of acquiring diabetes is 35-60%

Question 24

ANSWER THIS!!!!

Answer 24

6.5%

Due to the early treatment of diabetes is not invasive

Question 25

How does type 2 diabetes prevalances change in kids less than 10 years old and between 10-19 yo?

Answer 25

Question 26

What is a positive likelihood ratio?

Answer 26

LR+: 1 - test has no discriminatory value \>1 - Persons with disease more likely than persons without disease to have positive test \>10 - Test has high diagnostic value

Question 27

What is important about high specificity tests?

Answer 27

High specificity few false positives False negatives

Question 28

What are the symptoms associated with diabetes?

Answer 28

Question 29

Draw out a 2x2 table and write the equation for specificity and sensitivity

Answer 29

Question 30

How is the prevalance of diabetes distributes among different races?

Answer 30

Question 31

What is the best study design to compare two treatments?

Answer 31

Randomized control trial

Question 32

Discuss the process of choosing a cutoff point for fasting plasma glucose.

Answer 32

I**f you choose a cutoff point that is low, like 110, you get a more sensitive test (the test does a good job correctly identifying those with disease)**. Remember, a highly sensitive is useful in ruling out disease (SNNOUT): if a negative test result comes back from a highly sensitive test, we can have some confidence that it is a true negative result. If you choose a cutoff that is low, like 170, you get a more specific test (the test does a good job correctly identifying those without disease). A highly specific test is useful in ruling in disease (SPPIN).

Question 33

What is important to note about high sensitivity tests?

Answer 33

Few false negatives Higher false positives

Question 34

In a 2x2 table how would you determine the risk ratio?

Answer 34

Question 35

What is the validity of a test?

Answer 35

Ability to distinguish between who has and who doesnt

Question 36

Which med student was an honorary cheerleader for a day?

Answer 36

Brannon Donovan

Question 37

What are some risk factors associated with T2 diabetes? (7)

Answer 37

Obesity Physical inactivity Impaired glucose tolerance Prior history of gestational diabetes Older age FH of diabetes Race and ethnicity

Question 38

What is a likelihood ratio?

Answer 38