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This is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.
Deficient action of insulin on target tissues results in abnormalities in carbohydrate, fat, and protein metabolism.
Within the Diagnostic Criteria for Diabetes, there must be a Fasting Plasma Glucose (FPG) of what?
> or equal to 126 mg/dl
Within the Diagnostic Criteria for Diabetes, a diagnosis can be made if the patient exhibits symptoms of diabetes plus a casual glucose of what?
> or equal to 200 mg/dl
Within the Diagnostic Criteria for Diabetes, a diagnosis can be made with a 2 hour plasma glucose of _______ after 75 gm glucose load.
> or equal to 200 mg/dl
For a Pre-Diabetes diagnosis, the Impaired Fasting Glucose (IFG) is between _______ and ________.
The Impaired Glucose Tolerance (IGT) is a 2 hr PG > ______ and < ______.
- > 110 mg/dl and < 126 mg/dl
- >140 mg/dl and < 200 mg/dl
In Type I Diabetes, is insulin level or C-peptide high or low?
What are the markers of immune destruction in Type I Diabetes?
- ICA: islet cell autoantibodies
- IAA: autoantibodies to insulin
- GAD 65: autoantibodies to glutamic acid decarboxylase
In Type I Diabetes there is a strong HLA association with what genes?
In this subtype of Type I Diabetes, there is immune-mediated beta cell destruction. It is islet cell antibody positive. This is primarily a disease of caucasians, and there is genetic and environmental susceptibility.
Diabetes Type IA
In this subtype of diabetes, there are beta cell destructive processes going on other than immune-mediated. This type is islet cell antibody negative.
Diabetes Type IB
In Type II Diabetes, what is the primary symptom?
Resistance to the action of insulin
Are the insulin levels or C-peptide levels high or low in Type II Diabetes?
Normal or High
This is a stable minor hemoglobin component formed slowly and nonenzymatically from glucose and hemoglobin
This Diabetes Test measures the HbA1C, becuase its rate of formation is directly proportional to ambient ______ concentration. This test reflects the previous 2-3 months of glycemic control.
Within the ADA Standards of Care for Glycemic Control, what is the standard for the A1C test?
A1C test equal to or < 7%
Within the ADA Standards of Care for Glycemic Control, what is the standard for the Pre-Prandial BG?
Within the ADA Standards of Care for Glycemic Control, what is the standard for the Post-Prandial BG?
Within the ADA Standards of Care for Glycemic Control, how often should the A1C test be performed?
At least 2X/year if at goal, quarterly if therapy changing or not at goal
In trying to prevent cardiovascular complications with Diabetes, what is the target BP? What are the cholesterol or lipid profile goals?
- BP < 130/80
- LDL < 100
- TRIG < 150
- HDL > 40
What is a key component for the prevention of Cardiovascular complications in Diabetic patients?
Prescribe Aspirn 75-325 mg daily for those at increased risk of developing these complications
What are the screening recommendations for Nephropathy in Diabetic Patients?
Annual test for Microalbuminuria, Spot Albumin to Creatinine Ratio
How should a patient with a positive test for Microalbuminuria be treated?
With an ACE inhibitor to control BP -- lowering BP can lower Microalbuminuria
What are the screening recommendations for Retinopathy in Diabetic Patients?
- T1DM: dilated eye exam within 3-5 years of diagnosis
- T2DM: shortly after diagnosis
- Subsequent exams annually.
- Retinal Photography
In screening for Diabetic Complications, how often should a Comprehensive Foot Exam be done?
Yearly, more often in patients at high risk