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What are risk factors for development of DMII?
Age>45, BMI>24, 1st degree relative, sedentary lifestyle, high risk racial group (black, pacific islander, native american, asian american.), HTN, HDL<35, TRiglycerides>250, Imparired glucose tolerance (A1c>5.7 or FSG>100), PCOS, Gestational DM, Vascular disease.
How do you diagnose DMII?
- FSG> 126
- HBA1c >6.5%
- Random serum glucose >200 with sxs
- 2h OGTT > 200
What are sxs associated with DMII?
Polyuria, polydipsia, fatigue, blurred vision, -- in hyperosmolar hyperglycemia patients will also have altered mental status.
What are the complications associated with DMII?
Nephropathy, neuropathy (stocking and glove pattern), retinopathy, significantly increased risk of myocardial infarction, poor wound healing
What is the initial management of DMII?
Intense Lifestyle modification (diet AND exercise) + Metformin or if FG>250, long acting insulin. The patient should be followed closely until glucose levels are below 200. Depends on severity.
Is ASA an effective primary prevention method for cardiovascular disease in DMII in patient's without concurrent risk factors for CVD? (smoking, obesity, HTN etc?)
No. ASA should only be used in the primary prevention in patient's with DMII only if they have concurrent risk factors.