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Flashcards in Endocrine Deck (16)
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1

Recommendations for screening

Entire population > 45 every 3 years
Annual screening BMI >25 and one or more risk factors for DM

2

DM risk factors

Age greater than 45
BMI > 25
Family history
Physical inactivity
HTN
HDL 250
Women with PCOS
Hx vascular disease
Large infant

3

ADA Dx criteria for IIDM

1. AIC > 6.5
2. FBG > 126
3. 2 hour plasma glucose > 200 during OGTT
4. Random > 200 with sx of hyperglycemia

Criteria 1-3 needs to be confirmed with repeat testing

4

Prediabetes

fasting BG 100-125

5

acanthosis nigricans

Indicates insulin insensitivity

6

Common eye problems with diabetes

Microaneurysms - Red dots. Can leak and reduce vision.
Hemorrhages
Exudates - fatty deposits

7

Target AiC

< 7%
< 6% in pregnancy
< 7% with co-morbitities and limited anticipated lifespan

8

Target glycemic goals

Preprandial 70-130
Postprandial - < 180 (1-2 hours after eating)

9

Action of metformin

Reduces hepatic glucose production and enhances action of insulin

10

Sulfonylurea agents

(glimeperide, glipizide)
Potentiate insulin secretion
May cause hypoglycemia
Weight gain
Ideal use - insulinopenic patents, non-obese or mild obesity
Use in combo or monotherapy

11

Insulin (basal or NPH)

Sx weight gain, hypoglycemia
Stop sulfonylureas when initiating meal time insulin

12

When should you consider insulin

A1C > 10%
Fasting glucose > 250
Maxed out orals
Sx hyperglycemia
Pregnant patients

13

Initiating basal insulin

Total daily insulin needs for adults 1-1.2 u/kg/day
Start 0.2 u/kg as bolus or 10 units
Measure AM fasting glucose if FBG > 130 then increase basal insulin by 2-3 units every 2-3 days until at goal

14

Normal TSH

0.5-4.5 mU/L
Elevated = hypo
decreased = hyper

15

Primary hypothyroidism - replacement principles

Adults need 1.6mcg/kg/day

16

When should you recheck TSH after initiating therapy

4-6 weeks