chronic disease Flashcards
lipid monitoring can start when?
age 40
what A1c level is targeted for diabetic children and adolescents?
7.5 and under
criteria for diagnosis of diabetes
A1C>6.5 or
fasting glucose >126
or 2 hr glucose after OGTT >200
or in a pt w/ symptoms of hyperglycemia, a random glucose of >200
when should you test for diabetes in asymptomatic ppl?
adults of any age that are overweight or obese and who have 1 or more risk factors for diabetes
in those w/o these risk factors, begin testing at 45
if tests are normal, repeat tests every 3 yrs
when to screen pregnant for diabetes?
at first visit if risk factors for undiagnosed type 2 DM
at 24-28 wks if no risk factors for GDM
what level A1c prevents microvascular dis?
normal hemoglobin a1c for non diabetic
4-5.6
tx of type 1 diabetes
multiple daily injections (basal and bolus) or continuous subcu insulin infusion
in type 2 diabetes, if noninsulin monotherapy doesn’t help reach a1c goal in 3 months, what should you do?
add second oral agent or insulin
alcohol risk in diabetics
if consume much, can place pt at risk for delayed hypoglycemia
when is bariatric surgery recommended for type 2 diabetics?
BMI>35
BP goal for those with diabetes and HTN
what to do for pts w BP >120/80
advise lifestyle changes (weight loss, diet, decrease alcohol intake, exercise)
tx for those with diabetes and HTN should include
ACE inhibitor or ARB (level C evidence)
statins should be added to regimen for diabetics in what situations?
regardless of baseline lipid levels, if:
- overt CVD
- over 40 and have one or more risk factors for CVD
diabetic pts with CVD should get what tx
aspirin and statin
consider ACE inhibitor
for diabetics w/ elevated albumin secretion, what tx?
ACE or ARB
BP goal for over 60 yo
BP goal for under 60
in general nonblack population, initial anti-HTN tx, including for those with diabetes, should be
thiazide
Ca ch blocker
ACE
or ARB
in general black population, including those with diabetes, anti-HTN tx should include
thiazide
or Ca ch blocker
in 18 yo or older w HTN and CKD, initial therapy should include
ACE inhib or ARB to improve kidney outcomes
statin therapy is recommended in which groups
clinical atherosclerotic CVD
LDL>190
40-75 yo w/ diabetes and LDL 70-189
40-75 yo w/o diabetes but 10 yr clinical atheroscler CVD risk of >7.5%
