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59 terms

Type 2 Diabetes

STUDY
PLAY
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