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Flashcards in Prevention of Diabetes Deck (38):
1

What proportion of the US population has diabetes?

10%

2

Of those who technically have pre-diabetes, how many "know it?"

10%

3

Diabetes is the leading cause of what complications.

1) ESRD
2) new cases of blindness
3) non-traumatic limb amputations

4

Describe the pathophysiology of Type I Diabetes

autoimmune response destroys pancreatic beta-cells

5

Describe the pathophys of T2DM

not enough insulin or insulin resistance

6

T1DM makes up what proportion of all diabetes cases

10%

7

Describe the fasting plasma glucose test

measures the amount of glucose in the blood after an 8-10h fast

8

Describe the oral glucose tolerance test

after FPG, glucose is consumed and plasma drawn 1 & 2h later

9

Describe the glycosylated hemoglobin test

measures the % Hb bound to glucose to give the average plasma glucose concentration over the past 2-3 months

10

What is the name of the lab value determined from glycosylated hemoglobin test?

HbA1C or A1C

11

What is the normal range for FPG

<100 mg/dL

12

What is the normal range for OGTT @2h?

<140 mg/dL

13

what is the normal range for A1C?

< 5.7

14

What is the pre-diabetes range for FPG?

100-125 mg/dL

15

What is the pre-diabetes range for OGTT @ 2h?

140-199 mg/dL

16

What is the pre-diabetes range for A1C?

5.7 - 6.4

17

If FPG is in the pre-diabetic range you have...

IFG -- Impaired Fasting Glucose

18

If OGTT is within the pre-diabetic range, you have...

IGT -- Impaired Glucose Tolerance

19

How is pre-diabetes diagnosed?

IFG or IGT

20

Describe the prognosis for pre-diabetics

3-5y: 25% diabetic, 25% normal
5+ y: majority diabetic

21

If both IFG & IGT, what is the prognosis for diabetes?

50% of pts will go diabetic

22

How often should diabetes testing take place?

Every 3 years

(every 1 year for pre-diabetics)

23

Who should be tested for diabetes?

1) all > 45yo
2) overweight + 1 risk factor
3) symptomatic
4) overweight KIDS + 2 risk factors

24

What are risk factors for diabetes?

1) f/h
2) overweight (>25)
3) h/o CVD
4) prior IFG, IGT, AIZ > 5.7
5) HDL < 35 mg/dL
6) TG > 250 mg/dL
7) GDM or baby > 9#

25

Using the risk assessment tool for diabetes, what is "very low risk?"

0-2

26

using the risk assessment tool for diabetes, what is "low-medium" risk?

3-9

27

Using the risk assessment tool for diabetes, what is "high risk?"

10+

28

Describe the point-breakdown for the diabetes risk assessment tool.

9 pts: 65+ yo
5 pts: BMI 25+, 45-64yo
1 pt: parent, sibling, child >9#, exercise <4h/wk & 65+

29

What are the signs and symptoms of T2DM?

1) Thirst
2) + Urination
3) Hunger & Fatigue
4) Blurred vision
5) eczema
6) dry, itchy skin
7) slow thinking

can be asymptomatic

30

What was the conclusion of the DPP study?

1) metformin .5*effectiveness of BMOD
2) metformin better in young, obese pts

31

What was the conclusion of the ORIGIN study?

long-acting insulin reduced pre-diabetic to diabetic progression

32

How much does the NDPP lower diabetes risk?

50%

33

What are the 2014 ADA standards of care for prediabetes?

1) counsel if BMI > 25
2) weight loss (7%)
3) 150 mins/wk exercise
4) metformin if > 60, obese, prior GDM
5) treat underlying CV dz

34

How does the AACE define prediabetes?

IFG, IGT, or metabolic syndrome

35

How should a prediabetic pt be educated regarding exercise?

1) 150 min/wk
2) no more than 2 non-consecutive days
3) resistance training 3x/week

36

How should a prediabetic pt be educated regarding nutrition?

1) this is for all t1 & t2 dm pts
2) should receive individualized medical nutrition therapy
3) limit/avoid sugar-sweetened beverages
4) Na < 2300 mg/day

37

How should a prediabetic pt be educated regarding supplements?

1) no benefit from omega-3 supplements for CV
2) no conclusive vitamin/mineral evidence
3) insufficient cinnamon/herb evidence

38

How should a prediabetic pt be educated regarding weight management?

For t2dm, 5-10% at 1-2 #/wk