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10%

... % of US population is diagosed with diabetes

80

... million adult in US have prediabetes

3

there is a one in ... chance that a child in US born after 2000 will get diabetes

diabetes mellitus

... defined as relative hyperglycemia

metabolic syndrome

a clinical HX that may lead you to suspect a person has .... includes:
1. overweight-- with central adiposity
2. sedentary
3. HTN

metabolic syndrome

the diagnosis of ... is established when 3 or more of the following are present
1. abdominal obesity (increased waist circumfrnece)
2. elevated triglycerides
3. low HDL cholesterol
4. Raised BP
5. insulin resistance

40

a waist circumfrence in a man over ... inches is concerning for abdominal obesity, which can be seen in metabolic syndrome and type II diabetes

men

a waist circumfrence over 40 inches in ... is an indicator of abdominal obesity

35

a waist circumfrence over ... inches in women is concerning for abdominal obesity, which is concerning for metabolic syndrome and type II diabetes

women

a waist circumfrence over 35 inches in ... is concerning for abdominal obestity which is concerning for metabolic syndrome and type II DM

150

an elevated triglyceride level, seen in metabolic syndrome is over .... mg/dl

triglyceride

a ... leel over 150mg/dl is concerning for metabolic syndrome

40

an HDL cholesterol less than ... mg/dl in men is concerning for metabolic syndrome

men

an HDL cholesterol of less than 40 mg/dl in ... is concerning for metabolic syndrome

50

an HDL cholesterol of less than ... mg/dl in women is concerning for metabolic syndrome

women

an HDL cholesterol of less than 50 mg/dl in ... is concerning for metabolic syndrome

130/85

a raised BP above .... is considered a risk factor for metabolic syndrome

insulin resistance

... seen on a IFG, IGT or previous T2DM diagnosis can indicate ..., that is a risk factor for diagnosing metabolic syndrome

type II DM

we should screen the following people for ....:
1. age 45 or older
2. overweight (BMI >25)
3. Fam HX of DM
4. sedentary behavior
5. race/ethnicity
6. Hx of Impaired Fasting Glucose, Impaired Glucose Tolerance, Gestational DM
7. HTN
8. low HDL-cholesterol and/ or elevated triglycerides
9. PCOS
10. Hx of vascular disease

45

we should screen everyone age ... and older for type II DM

overweight

we should screen everyone who is ... (BMI> 25) for type II DM

25

we should screen everyone who is overweight (BMI>.....) for type II DM

family HX

we should screen everyone who has a ... of type II DM

sedentary

we should screen everyone who has ... behavior for type II DM

race/ethnicity

we should screen everyone who is of a certain ... that is at higher risk of developing DM

IFG, ITG, GDM

we should screen everyone who has a .... in their past medical historty for DM

HDL

we should screen everyone who has a low... cholesterol for type II DM

triglycerides

we should screen everyone who as elevated ... for type II DM

PCOS

we should screen all women with ... for DM

pregnant

we should screen all ... women for DM

vascular disease

we should screen all people with a HX of ... for type II DM

age

... is the biggest risk factor for developing type II DM

fasting plasma glucose, glucose tolerance test, and HbA1c

the following 3 tests: .... are the best screening tests for type II DM

2

a provider needs ... abnormal test results (IGF, IGT, abnormal HbA1c) to diagnose type II DM (usually taken on different days

random

a ... glucose test is not the best test for type II DM

100

a normal fasting blood glucose level in adults is less than ....

100-125

a fasting blood glucose level between .... indicates an increased risk of type II DM

126

a fasting blood glucose level greater than ... is abnormal, and is seen in type II DM

140

a 2 hour post prandial glucose level less than ... is normal

140-199

a 2 hour post glucose test level between ... is at increased risk for developing type II DM

200

a 2 hour post glucose tolerance test level greater than 200 is abnormal and seen in type II diabetes

5.7

a normal HbA1c level is less than ...

5.7-6.4

a HbA1c level between... puts a person at increased risk of developing type II DM

6.5

a HbA1c level of ... or greater is abnormal and is seen in type II DM

random

a ... blood glucose level is not very indicative of type II diabetes (unless way over 200 with symptoms)

metabolic syndrome

management for a person with suspected .... needs to be screened for type II DM (fasting blood glucose and HbA1c), screened for CV disease (lipids, BP), encouraged to loose weight (better diet) and increase exercise

acute

the ... management for type II diabetes once patient is in office with diagnosis, is to reverse the acute symptoms of hyperglycemia- hopefully will feel better and increase compliance with future therapies

symptoms of hyperglycemia

the acute management for type II diabetes is to reverse the acute .... which will hopefully make the patient feel better and increase his/her compliance wiht future therapies

chronic

the ... management for type II diabetes includes:
1. Glycemic Control to prevent microvascular complications like neuropathy, Nephropathy, Retinopathy
2. Prevent macrovascular complication?- MI,stroke etc-- so screen for it, and lifestyle modifcations (diet and exercise)
3. Minimize hypoglycemia
4. BP control: < 130/80
5. Treatment of Metabolic Dyslipidemia
6. Other CRFs: smoking cessation, ASA therapy if indicated

glycemic control

... is one of the key stones of chronic management of type II diabetes to prevent microvascular complications like neuropathy, nephropathy and retinopathy

neuropathy, nephropathy, and retinopathy

... are three of the microvascular complications of type II diabetes that can be controlled by having good glycemic control

hypoglycemia

and with better glycemic control in the management of type II DM will minimize ... episodes that can be unpleasant

130/80

BP managment, so BP under .... is part of chronic management of type II DM--so increase exercise, improve diet, and maybe medication

dyslipidemia

treatment of metabolic .... is also part of type II diabetes chronic management-- with diet and exercise changes as well as perhaps medication

HbA1c

any reduction in ... levels above the normal level will help to decrease the risk of microvascular complications

7

a HbA1c less than ... is ideal in the chronic management of type II diabetes (but should be individualized to patient

HbA1c

lowering ... levels to less than 7, is ideal, but may not be appropriate for some patients (due to risk of hypoglycemic experiences, or other adverse side effects)

90-130

a prepradial plasma glucose level between ... is ideal for chronic management of type II DM

180

a post prandial plasma glucose level less than ... is ideal for the chronic management of type II DM

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