thera DM, non Tx stuff

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coal
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243841
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thera DM, non Tx stuff
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2013-10-30 00:47:06
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thera DM non Tx stuff
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thera DM, non Tx stuff
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  1. criteria for a diagnosis of diabetes
    • A1C > 6.5%
    • FBG > 126 mg/dl
    • symptoms of DM + random glucose > 200 mg/dL
    • 2 hour plasma glucose > 200 during OGTT
  2. criteria for pre-diabetes
    • A1C 5.7-6.4%
    • FPG 100-125 mg/dL
    • OGTT 140-199 mg/dL
  3. 12 risk factors for DM
    • obesity/overweight BMI >25 kg/m2
    • physical inactivity
    • 1st degree relative with DM
    • high risk ethnicity
    • women w/history of GDM or baby > 9 lbs
    • PCOS
    • history of CVD
    • HDL < 35 mg/dL
    • triglycerides > 250 mg/dL
    • HTN: BP > 140/90 mmHg or on treatment
    • Resistance conditions
    •   BMI > 40 kg/m2
    •    Acanthosis Nigrans
  4. High risk ethnicity/race groups for DM
    • African american
    • latino
    • native american
    • Asian american
    • pacific islander
  5. microvascular complication from DM
    • nephropathy
    • retinopathy
    • neuropathy
    • foot ulcers/lesions
    • numbness, pain
    • sexual dysfunction
    • gastroparesis
  6. macrovascular complications of DM
    • cardiovascular disease - CVD
    • coronary artery disease - CAD
    • myocardial infarction - MI
    • stroke or transient ischemic attack - TIA
    • peripheral artery disease - PAD
  7. 3 adult groups that should receive screenings for DM
    • all adults (>18 yo) with BMI > 25 kg/m2 and 1 or more risk factors
    • adults w/o risk factors - start at age 45
    • pt w/pre-diabetes values - yearly
  8. ADA goals for DM
    • A1C < 7%
    •    6.5% if short duration of DM, long life
    •    expectancy and significant CVD
    •   <8% for hypoglycemia, elderly & pregnancy
    • pre-prandial 70-130
    • postprandial <180
  9. BP goal for DM
    <140/<80
  10. LDL goals for DM
    • < 100 mg/dL w/o CVD
    • < 70 mg/dL w/ CVD
  11. triglyceride goal for DM
    < 150 mg/dL
  12. HDL goal for men and women with DM
    • men - > 40 mg/dL
    • women - > 50 mg/dL
  13. 4 broad Tx goals of DM
    • relieve symptoms
    • prevent or slow progression of complications
    • minimize cardiovascular risks
    • improve quality of life

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