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What are the characteristics associated with metabolic syndrome?
- Waist > 40in in men; > 35in in women
- TG > 150
- HDL < 40 for men; < 50 for women
- Insulin resistance (with or w/o glucose intolerance)
What are the 5 risks for cardiovascular complications in diabetes?
- Immunizations (give them)
- (Thrombus formation)
What is the BP goal for diabetes?
- < 130/80
- 110-129/65-79 in pregnant diabetics
- if under 140/90 = lifestyle modification x 3mo
- if 140/90 or higher = lifestyle mod + pharmacotherapy
What is lifestyle modification for HTN in diabetes?
- DASH diet
- Wt loss
- Alcohol moderation
What is the recommended pharmacotherapy for HTN in diabetes?
- ACE inhibitor
- Monitor K, renal fx, BP
- (Methyldopa, Labetolol, Diltiazem, Clonidine, Prazosin in Pregnancy)
What are the goals for lipids in diabetes?
- LDL < 100 (70 if possible)
- HDL > 40 in men; > 50 in women
- TG < 150
- Use statins (except in pregnancy)
- If LDL goal cannot be reached, decrease it by 30-40% of baseline
When should ASA be recommended for thrombus prevention?
- Primary prevention:
- if 10yr risk > 10% (male > 50yo, female > 60yo, + HTN, family hx of CVD, smoking, dyslipidemia, OR albuminuria)
- Secondary prevention:
- if personal hx of CVD
What are the 5 As of smoking cessation?
What therapies should be initiated in diabetics with established CVD?
- Post-MI: beta-blockers for at least 2yrs
- Metformin okay if stable CHF and normal renal fx
- NO TZDs
What is the schedule for immunizations in diabetes?
- every year
- > 64yo if orignal vaccine < 65 and at least 5 yo ago