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Criteria for Metabolic Syndrome
3 of 5 required for diagnosis:
* Abdominal obesity: waist circumference > 35inch. in Men, > 40inch. Women
* Glucose intolerance: FBG > or = 110
* Elev.TG: > or = 150
* Low HDL-C: < 40 men, < 50 women
A cluster of factors that drastically increase one's risk of CVD and DM
- mild risk of complications; initiate nutrition change, physical activity, behavior management, medication
Obese, Class I BMI
- moderate risk of complications; initiate nutrition/physical/behavioral change, medication
Obesity, Class II
- High risk of complications; initiate nutrition/physical/behavior change, medication & Surgical options
BMI > or = 40
-Extreme risk of complications; initiate nutrition/physical/behavioral change, medications, bariatric surgery
Caloric Restriction in Obesity
Goal: 5-10% weight loss in 12 mos.
BMI 27-35 - cut 300-500kcal/day to equal 1lb loss/week (10% in 6mos)
BMI > 35 - cut 500-1000kcal/day to equal 10% weight loss in 6 mos
Calculate from BME (basal metabolic energy), current wt. in lbs x10
q3mos if change in regimen or not at goal.
q6mos if at goal.
DM testing/screening in asymptomatic adults (ADA)
Begin at age 45y.o. & q3years.
If prediabetic, yearly.
- overweight, physically inactive, high-risk ethnicity, had a baby > 9lbs or GDM, HTN, HDL <35, TG >250, PCOS, A1C > or = 5.7, IGT, IFG, S&S of insulin resistance (acanthosis nigricans), or hx of CVD.