3.4.1 Epidemiology of Diabetes Flashcards

1
Q

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

A

9% of all adults >18yo

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2
Q

When is screening recommended for diabetes?

A

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

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3
Q

What point on this graph is perfectly sensitivity?

A

B

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4
Q

High sensitivity and a negative result will do what?

A

SNOUT

High sensitivity will and a negative result will rule out disease

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5
Q

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

A

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

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6
Q

What is sensitivity?

A

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

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7
Q

Is the oral glucose tolerance test good?

A

Most sensitive test

Likelihood ratio is 9.46

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8
Q

What is pretest probability?

A

Probability of a disease before a test is done

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9
Q

What are the risk factors associated with Type 1 diabetes?

A

Autoimmune, genetic and environmental

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10
Q

What is prediabetes?

A
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11
Q

What point on this graph is perfect specificity?

A

E

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12
Q

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

A
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13
Q

What is the prevalance of diabetes among the US population?

A
  1. 3%
  2. 1m people

28% undiagnosed

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14
Q

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

A

The test would have a lower sensitivity and increase the specificity

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15
Q

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

A
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16
Q

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

A
17
Q

How does percentage of people with diabetes change with age?

A

Increases with age

20-44 : 4.1%

45 - 64 : 16.2%

>64 : 21.8%

18
Q

What is the specificity of a test?

A

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

19
Q

How is obesity distributed through the United States?

A
20
Q

What is SPIN?

A
21
Q

What is diabetes mellitus?

A

Disease where blood glucose levels are elevated

Cause - Insufficient insulin or insulin resistance

22
Q

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

A

Using a normogram.

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

23
Q

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

A

Risk of acquiring diabetes is 35-60%

24
Q

ANSWER THIS!!!!

A

6.5%

Due to the early treatment of diabetes is not invasive

25
Q

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

A
26
Q

What is a positive likelihood ratio?

A

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

27
Q

What is important about high specificity tests?

A

High specificity few false positives

False negatives

28
Q

What are the symptoms associated with diabetes?

A
29
Q

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

A
30
Q

How is the prevalance of diabetes distributes among different races?

A
31
Q

What is the best study design to compare two treatments?

A

Randomized control trial

32
Q

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

A

If 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).

33
Q

What is important to note about high sensitivity tests?

A

Few false negatives

Higher false positives

34
Q

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

A
35
Q

What is the validity of a test?

A

Ability to distinguish between who has and who doesnt

36
Q

Which med student was an honorary cheerleader for a day?

A

Brannon Donovan

37
Q

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

A

Obesity

Physical inactivity

Impaired glucose tolerance

Prior history of gestational diabetes

Older age

FH of diabetes

Race and ethnicity

38
Q

What is a likelihood ratio?

A