5 Diabesity Flashcards
BMI for Orlistat
> 30 or >28 with associated risk factors
Should only continue treatment with orlistat if the person has lost at least what percentage of their initial body weight since starting drug treatment?
5%
Orlistat contraindications
Cholestasis, pregnancy, breastfeedinng, oral anticoagulant, ciclosporin.
Minimum age to have orlistat
18 years
Local anaesthetic
Should be used when undergoing bariatric surgery has people with high BMI have higher risk of anaesthetic death.
BMI that NICE recommends you should be to be considered for bariatric surgery
.>40 or 35-40 and another disease that could be improved if they lost weight
Consider surgery as a first line weight loss option for people with a BMI of what?
> 50
Requirements from NICE for bariatric surgery
All appropriate non-surgical measures have failed to achieve/maintain adequate weight loss for at least 6 months
receiving/will receive intensive specialist management
generally fit for anaesthesia and surgery
commit to the need to long term follow up
decision jointly with the patient
Carry out a comprehensive assessment of any psychological or clinical factors that could affect adherence to post-operative care needs
Implications of medicines with bariatric surgery
Effervescent tablets form gas bubbles
Increased side effects as you have decreased surface area
Avoild liquid diet
Burst band - infection - pain
What is used for the 75g oral glucose load
Polycal, 113ml
Fasting plasma glucose level that indicated diabetes
> 7mmol/L
Plasma glucose level 2 hours after a 75g oral glucose load that indicated diabetes
> 11mmol/L
People with this are indicative that they have glucose in their urine
Recurrent thrush
If you have a glucose level of 7.9-11mmol/L, you may have this
Impaired glucose tolerance
The HbA1c test should glood glucose levels over what preceding time?
2-3 months
Normal HbA1c target
<48mmol/mol (6.5%)
HbA1c target for individuals at risk of severe hypoglycaemia.
<58mmol/mol (7.5%)
Target BP for people with diabetes
140/80
Target BP for people with diabetes with co-existing renal disease
135/75
1st line antihypertensives for people with T2 diabetes, if indicators of renal disease present
ACEI or A2RB
1st line antihypertensive for people with T1D
Thiazide
NICE target for total cholesterol in people with diabetes
<5mmol/L
