Diabetes

Question 1

What are the classes of risk factors for Type 2 Diabetes?

Answer 1

1- Family History
2- High Risk Demographic Group
3- Personal History of Diabetes associated Conditions
4- Presence of end-organ dysfunction
5- Medications associated with Diabetes

Question 2

Which demographic groups are at higher risk for T2DM?

Answer 2

-Those with low SES.
-Ethnic Africans,
-Arabs,
-Asians,
-Hispanics,
-Indigenous
-South Asian Descent

Question 3

What are the end-organ dysfunctions we are referring to when talking about microvascular and macrovascular complications of diabetes?

Answer 3

Micro: Nephropathy, Neuropathy, retinopathy
Macro- CAD, Cerebrovascular disease, and Peripheral Vascular Disease.

Question 4

What are some diabetes-associated conditions that increase a patient’s risk for diabetes?

Answer 4

Gestational Diabetes
Pancreatitis
PCOS
CF
Acanthuses Nigricans
Gout
NASH
OSA
HIV
psychiatric diseases

Question 5

Which classes of medications can increase the risk for Type 2 Diabetes

Answer 5

Steroids,
Atypical Antipsychotics,
HAART,
Statins

Question 6

What are the 5 criteria of metabolic syndrome and their cut-offs?

Answer 6

1 - Waist circumference ->= 102 cm (M); >= 88 cm (F).
2 - Triglycerides. >=1.7 mol/L
3 - Low HDL-C <1.0 (M), <1.3 (F).
4 - Elevated BP or tx for HTN, SBP>= 130, DBP >=85
5 - Elevated FPG or diabetes Tx FPG >5.6

Question 7

List the cut-points for diagnosis of diabetes and pre-diabetes compared with normal glucose levels.

Answer 7

Diabetes - FPG >=7.0, A1C >= 6.5, 2HrOGTT >=11.1, Random sugar >=11.1 with symptoms.
Pre-Diabetes - FPG 6.1-6.9, A1C, 6.0-6.4, 2HrOGTT 7.8-11.0
At-Risk -> FPG 5.6-6.9 or A1C 5.5-5.9

Question 8

How often should patients over the age of 40 be screened for diabetes with screening lab work?

Answer 8

Every 3 years with FPG and A1C, Yearly risk stratification with risk calculator, if high-risk, can do yearly screen with labs.
-Those with risk factors can be screened more frequently - q12mo.

Question 9

How often should A1C and blood pressure be checked in a person with T2DM?

Answer 9

every3-6 months.

Question 10

What Blood pressure target is used for patients with T2DM?

Answer 10

130/80

Question 11

What tests or physical examinations should be done annually in a patient with diabetes?

Answer 11

-Fasting Lipids
-ACR and Creatinine
-Monofilament and Foot exam
-Optometry

Question 12

What is included in a diabetic foot exam?

Answer 12

Monofilament exam
check ROM
check skin
neuropathy testing
Peripheral pulses, peripheral arterial disease

Question 13

What scoring system is used to help determine A1C targets in T2DM?

Answer 13

Frailty score