3. Prevention or Delay of Diabetes

Question 1

What were the most common adverse reactions observed WITH Teplizumab?

Answer 1

The most common adverse reactions observed were lymphopenia followed by rash.

Question 2

What was the difference in median time to stage 3 type 1 diabetes diagnosis between the teplizumab and placebo groups?

Answer 2

The difference in median time to stage 3 type 1 diabetes diagnosis between the teplizumab and placebo groups was 25 months.

Question 3

What is the age range for pediatric patients who can be treated with teplizumab?

Answer 3

Pediatric patients 8 years of age and older with stage 2 type 1 diabetes can be treated with teplizumab.

Question 4

What is the recommendation regarding teplizumab-mzwv infusion for type 1 diabetes?

Answer 4

Teplizumab-mzwv infusion should be considered in selected individuals aged ≥8 years with stage 2 type 1 diabetes to delay the onset of symptomatic type 1 diabetes.

Question 5

In what type of setting should the management of teplizumab-mzwv infusion for type 1 diabetes be done?

Answer 5

The management of teplizumab-mzwv infusion for type 1 diabetes should be done in a specialized setting with appropriately trained personnel.

Question 6

What care goals should be included in adults with overweight/obesity at high risk of type 2 diabetes?

Answer 6

The care goals should include weight loss or prevention of weight gain, minimizing the progression of hyperglycemia, and attention to cardiovascular risk and associated comorbidities.

Question 7

When should pharmacotherapy be considered in person-centered care goals for individuals at high risk of type 2 diabetes?

Answer 7

Pharmacotherapy may be considered to support person-centered care goals for weight management, minimizing the progression of hyperglycemia, and cardiovascular risk reduction.

Question 8

Which individuals should more intensive preventive approaches be considered for in terms of progression to diabetes?
مواصفات الناس اللي يستحقون علاج فترة ماقبل السكري؟

Answer 8

1. BMI ≥ 35 kg/m2: Indicates obesity and increased health risks.
2. Higher glucose levels:
   
   • Fasting plasma glucose: 110-125 mg/dL (impaired fasting glucose).
   • 2-hour postchallenge glucose: 173-199 mg/dL (impaired glucose tolerance).
   • A1C ≥ 6.0%: Poor blood sugar control over time.
3. History of gestational diabetes: Increases the risk of developing type 2 diabetes.

Question 9

Should statin discontinued in concern DM?

Answer 9

No discontinuing statins due to concerns of diabetes risk in the population studied.

Question 10

What benefits of statin therapy outweigh the risk of diabetes, according to the article?

Answer 10

The cardiovascular and mortality benefits of statin therapy exceed the risk of diabetes, according to the article.

Question 11

What was the association between statin use and diabetes risk in the DPP?
Hazard ratio?

Answer 11

HR = 1.36

Question 12

For 1ry prevention of HTN DLP, PRE DIABETES PT SHOULD BE CATEGORISED BASED ON?

Answer 12

based on their level of cardiovascular risk.

Question 13

What is the primary prevention approach for people with prediabetes in terms TO PREVENT
cardiovascular disease?

2 IMPORTANT THINGS

Answer 13

Treatment goals and therapies for hypertension and dyslipidemia should be based on their level of cardiovascular risk.

Question 14

What should we do for pt on statin + thiazid + BB at risk for DM2?

Answer 14

Glucose status should be monitored regularly.

pravastatin should be preferred over other statins

Question 15

What is the suggested treatment for people with a history of stroke and evidence of insulin resistance and prediabetes?

Answer 15

Pioglitazone may be considered to lower the risk of stroke or myocardial infarction.

Question 16

What are the potential risks associated with using pioglitazone for people with a history of stroke and evidence of insulin resistance and prediabetes?

Answer 16

Weight gain, edema, and fracture.

Question 17

What is the association between prediabetes and cardiovascular risk?

Answer 17

Prediabetes is associated with heightened cardiovascular risk.

Question 18

At what time point was the risk of low B12 levels significantly greater in the DPP study?بعد كم سنة

Answer 18

The risk of low B12 levels was significantly greater at 5 years in the DPP study.

Question 19

Who should metformin be recommended as an option for?

Answer 19

Metformin should be recommended as an option for high-risk individuals (e.g., those with a history of GDM or those with BMI ≥35 kg/m)

Question 20

What was the reduction in diabetes risk observed in individuals with a history of GDM in the DPP?
بعد ما بدو لايف ستايل وميتفورمين

Answer 20

equivalent 50% reduction in diabetes risk.

Question 21

What is the feature of metformin that makes it suitable for diabetes prevention?
كم نسبة تنزيل المنطم واللايف ستايل بعد ٣ سنوات؟
DPP STUDY

Answer 21

Metformin :reduced the 3-year risk of diabetes by -31%.

LSM: -58% for intensive lifestyle intervention .

Question 22

Is there any FDA MEDS APPROVED TO prevent T2DM?

Answer 22

No

Question 23

What was the outcome of the Vitamin D and Type 2 Diabetes (D2d) trial?

Answer 23

The trial showed no significant benefit of vitamin D versus placebo on the progression to type 2 diabetes in individuals at high risk.

Question 24

Which HTN pharmacologic agent has shown some efficacy in diabetes prevention?

Answer 24

Valsartan

Question 25

According to the study, which HTN pharmacologic agents did not show efficacy in preventing diabetes?

Answer 25

Ramipril and anti-inflammatory drugs

Question 26

Which medications evaluated for weight loss have been shown to decrease the incidence of diabetes in those with prediabetes?

5meds

Answer 26

Orlistat, phentermine topiramate, liraglutide, semaglutide, and tirzepatide.

Question 27

How are candidates for orlistat, phentermine topiramate, liraglutide, semaglutide, and tirzepatide?

Answer 27

Prediabetes.
Who need at loss

Question 28

By how much does the risk of type 2 diabetes increase in postpartum individuals with GDM for every 1 unit increase in BMI above the preconception baseline?

Answer 28

Each +1BMI PRECONCEPTION = 18%

Question 29

What was the reduction in risk of progression for every kilogram of weight loss in the DPP study?

Answer 29

Each -1KG = -16% lower risk T2DM.
Over 3 years.

Question 30

Which pharmacologic agent has been shown to lower the incidence of diabetes in specific populations? T2DM

كثيرة لازم تعرفها

Answer 30

Metformin, α-glucosidase inhibitors, glucagon-like peptide 1 receptor agonists (liraglutide, semaglutide), thiazolidinediones, testosterone (61), and insulin have been shown to lower the incidence of diabetes in specific populations.

Question 31

Is Nateglinide shows diabetes T2 prevention?

Answer 31

Nateglinide did not show diabetes prevention.

Question 32

According to the recommendations, when should metformin therapy for the prevention of type 2 diabetes be considered?

Answer 32

Metformin therapy for the prevention of type 2 diabetes should be considered in adults at high risk of type 2 diabetes.

Question 33

What are the factors that typify adults who should be considered for metformin therapy for the prevention of type 2 diabetes?

Answer 33

1. Age: Adults aged 25-59 years.
2. BMI: Body Mass Index (BMI) should be equal to or greater than 35 kg/m2.
3. Fasting Plasma Glucose: Fasting plasma glucose levels should be equal to or higher than 110 mg/dL.
4. A1C: A1C levels should be equal to or higher than 6.0%.
5. Prior Gestational Diabetes: Individuals who have had gestational diabetes mellitus in the past.

Question 34

What potential deficiency may be associated with long-term use of metformin?

Answer 34

Long-term use of metformin may be associated with biochemical vitamin B12 deficiency.

Question 35

What types of eating patterns are associated with a lower risk of developing type 2 diabetes?

Answer 35

Vegetarian, plant-based (may include some animal products), and Dietary Approaches to Stop Hypertension (DASH)eating patterns.

Question 36

What is the recommended approach to determining macronutrient distribution for preventing diabetes?

Answer 36

Macronutrient distribution should be based on an individualized assessment of current eating patterns, preferences, and metabolic goal.

Question 37

Is there an ideal percentage of calories from carbohydrate, protein, and fat for preventing diabetes?

Answer 37

No, evidence suggests that there is not an ideal percentage of calories from carbohydrate, protein, and fat for all people to prevent diabetes.

Question 38

According to the DPP study, what was the most important factor in reducing the risk of incident diabetes?

Answer 38

ـWeight lossـ

Question 39

By achieving the target behavioral goal of at least 150 min of physical activity per week, what percentage reduction in the incidence of type 2 diabetes was observed, even without achieving the weight loss goal?

Answer 39

-44%

Question 40

What ADA RECOMMENDS TO PREVENT DM
2 APPROACHS

Answer 40

1. Weight Loss: Achieve and maintain a minimum of 7% weight loss.
2. Physical Activity: Engage in 150 minutes of moderate-intensity physical activity per week.

Question 41

According to the DPP study, what was the percentage reduction in the risk of incident type 2 diabetes over 3 years with intensive lifestyle intervention?
BOTH WT LOSS AND EXERCISES

Answer 41

The DPP study demonstrated a58% reduction in the risk of incident type 2 diabetes over 3 years with intensive lifestyle intervention.

Question 42

What were the reductions in the risk of progression to type 2 diabetes observed in the Da Qing study, Finnish DPS, and the U.S. Diabetes Prevention Program Outcomes Study?

Answer 42

The reductions in the risk of progression to type 2 diabetes were 39% reduction at 30 years in the Da Qing study, 43% reduction at 7 years in the Finnish DPS, and 34% reduction at 10 years and 27% reduction at 15 years in the U.S. Diabetes Prevention Program Outcomes Study (DPPOS).

Question 43

What are the recommendations for adults with overweight/obesity at high risk of type 2 diabetes?

Answer 43

Refer them to an intensive lifestyle behavior change program to achieve and maintain a weight reduction of at least 7% of initial body weight through healthy reduced-calorie diet and ≥150 min/week of moderate-intensity physical activity.

Question 44

What is the recommendation regarding eating patterns to prevent diabetes in individuals with prediabetes?

Answer 44

A variety of eating patterns can be considered to prevent diabetes in individuals with prediabetes.

Question 45

Why should diabetes prevention programs be covered by third-party payers?

Answer 45

Diabetes prevention programs should be covered by third-party payers due to their cost-effectiveness and to address inconsistencies in access.

Question 46

What is the recommendation regarding certified technology-assisted diabetes prevention programs?

Answer 46

Based on individual preference, certified technology-assisted diabetes prevention programs may be effective in preventing type 2 diabetes and should be considered.

Question 47

How often should individuals with prediabetes be monitored for the development of type 2 diabetes?

Answer 47

at least annually.