8: DM Screening Flashcards
Most testing requires confirmation to diagnose DMT2. In a patient with classic symptoms of hyperglycemia or hyperglycemia crisis, what random glucose level is considered diagnostic?
200+
What is a normal FPG?
<100
What random glucose level would indicate DM?
200+
What are HbA1C levels in prediabetes?
5.7-6.4
What are HbA1C levels in DM?
6.5+
What is a FPG that diagnoses DM (with confirmation)?
126+
What is an impaired FPG (prediabetes)?
100-125
Regardless of risk, at what age should DMT2 screening start for all individuals and how often?
- 45+
- If normal, repeat in 3 years
What 10 risk factors indicate testing for DMT2 at a younger age?
- BMI >25
- First-degree relative with diabetes
- Physically inactive
- High-risk ethnic population
- Delivered a 9 pound+ baby or Hx of GDM
- BP ≥140/90
- PCOS or acanthosis nigricans
- History of vascular disease
- HDL ≤35 and triglyceride ≥250
- Impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) at previous testing
What 2 tests are preferred for DMT2 screening?
- Fasting plasma glucose
- 2-hour GTT (75 grams, should be less than 140 at 2-hour mark)
In the patient with prediabetes, what are the 3 main goals?
- Weight loss of 7%
- 150 min/week of moderate physical activity
- Follow-up with counseling, praise
For those at highest risk of DMT2, what med can be used to prevent or delay it?
- Metformin
- If using it, monitor FPG yearly, not every 3 years
What glucose level in the 2-hour GTT indicates impaired glucose tolerance?
140-199
When should asymptomatic children be tested for DMT2?
- Overweight: BMI > 85th percentile for age and sex
- Weight for height > 85th percentile
- Weight >120% of ideal for height
- Plus any 2:
- Family hx in 1st or 2nd degree relative
- High-risk ethnic population
- Signs of insulin resistance:
- Acanthosis nigricans
- HTN
- Low birth weight for gestational age
- PCOS
- Dyslipidemia
- Maternal hx of DM or GDM during child’s gestation
What glucose level in the 2-hour GTT indicates DM?
200+
