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NURP 502 - Ex 3 > 8: DM Management > Flashcards

8: DM Management Flashcards

1
Q

Name 4 macrovascular complications of DM.

A
  1. CAD
  2. MI
  3. CVA
  4. PVD (arterial)
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2
Q

How often should a foot exam with monofilament be performed?

A

2x/year (minimum)

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3
Q

Other than height, weight, BMI, and BP which are collected at most physical exams, what specific other areas need to be examined?

A
  • Fundoscopic exam
  • Thyroid palpation
  • Skin exam
    • Check for acanthosis nigricans and atrophy at injection sites
  • Comprehensive foot exam
    • Inspect
    • Palpate pulses
    • Check for DTRs
    • Evaluate monofiliment and proprioception sensation
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4
Q

How often should blood sugar be monitored at home?

A
  • 3-4x/day
  • Prior to meals/snacks
  • Postprandial (occasionally)
  • Bedtime
  • Prior to exercise
  • Suspected hypoglycemia
  • Post hyperglycemia treatment
  • Prior to critical tasks
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5
Q

What 6 potential initial diagnostics would you order in DM?

A
  1. HgA1C
  2. Fasting lipids
  3. LFTs
  4. UA (glucose, microalbuminuria, ketones)
  5. TSH (women 50+ or T1 or dyslipidemia)
  6. Baseline EKG (not recommended–use judgement)
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6
Q

What is the HDL goal for men and women with DM?

A
  • >45 in men
  • >55 in women
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7
Q

In preexisting DM in pregnancy, what should the A1C be?

A
  • < 6
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8
Q

What is the preprandial glycemic target for nonpregnant patients?

A
  • 70-130
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9
Q

What drugs should be used for lipid management in DM?

A
  1. Statins
  2. Fibrates
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10
Q

How often should a dental exam be performed?

A
  • 2x/year
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11
Q

Metformin should be used for patients with stable HF so long as _____ is normal.

A

Metformin should be used for patients with stable HF so long as creatinine is normal.

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12
Q

Normally, insulin sensitizers vs insulin does not make a difference in overall CVD outcomes. However, what small group might benefit from reduced risk of MI d/t using insulin sensitizers?

A

Patients undergoing prompt revascularization/CABG

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13
Q

How often should a dilated eye exam be performed?

A

Yearly

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14
Q

How long should BB be used in DM patients with prior MI?

A

At least 2 years

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15
Q

What is the A1C target for nonpregnant patients?

A

≤7%

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16
Q

In preexisting DM in pregnancy, what should the premeal, bedtime, and overnight BG be?

A

60-99

17
Q

When should continuous glucose monitoring (CGM) be used?

A
  • Type 1
  • Type 2 on intensive insulin regimens
  • Patients with hypoglycemia unawareness
  • Patients with frequent hypoglycemic episodes
18
Q

In GDM, what should the preprandial BG be?

A

≤95

19
Q

In GDM, what should the 1-hour postprandial be?

A

≤140

20
Q

How often do you test A1C for DM patients who are not at goal or who are having their treatment changed?

A

Q 3 months

21
Q

How often should microalbumin UA be performed?

A

4x/year

22
Q

What 6 referrals would you consider when diagnosing DM?

A
  1. Opthalmologist (dilated eye exam)
  2. Medical nutritionist
  3. Diabetes educator
  4. Podiatrist
  5. Dentist
  6. Family planning counselor (women of reproductive age)
23
Q

What initial drugs should be considered in HTN for DM?

A
  1. ACEs
  2. ARBs
  3. BBs
  4. Diuretics
24
Q

What HgA1C level indicates to maximize lifestyle modifications with the current treatment?

A

7-8

25
Q

T/F DM can lead to dental disease.

A

True

26
Q

How often should LFT and KFT levels be measured?

A

2x/year

27
Q

How often should Hg1AC be measured?

A
  • 2-4x/year
  • 2 if meeting goals
  • 4 if not meeting goals or changing therapy
28
Q

In preexisting DM in pregnancy, what should the peak postprandial BG be?

A

100-129

29
Q

T/F DM patients can have impaired immune responses, leading to an increased incidence of infections.

A

True

30
Q

How often should lipid levels be measured?

A

Yearly (if controlled)

31
Q

What is the postprandial glycemic target for nonpregnant patients?

A
  • < 180 at 2 hour mark
32
Q

T/F DM can lead to psychosocial disease.

A

True

33
Q

What HgA1C indicates the need for treatment adjustment?

A

8+

34
Q

In GDM, what should the 2-hour postprandial be?

A

≤120

35
Q

Name 6 microvascular complications of DM.

A
  1. Retinopathy
  2. Neuropathy
  3. Nephropathy
  4. Sexual dysfunction
  5. Peripheral skin ulcerations
  6. Amputations
36
Q

Why are multiple point-of-care tests so important in DM?

A

It allows for timely decisions regarding therapy changes.

37
Q

Who should have UA ketone testing?

A
  1. Type 1
  2. Pregnant patients with pre-existing DM
  3. GDM
  4. Glucose 300+
  5. N/V and abdominal pain (ketoacidosis)
38
Q

What drugs should be used for CVD management in DM?

A
  • ACE + ASA + Statin (if no contraindications)

NURP 502 - Ex 3 (37 decks)

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