Diabetes

Question 1

Risk factors for T2DM

Answer 1

Dyslipidemia
Overweight/obesity
Abdominal obesity
Hypertension
First degree relative with t2dm
Steroid use
Schizophrenia
Use of second gen antipsychotics (olanzapine, quetiapine, risperidone, clozapine)
Age 40-70
High risk populations (Hispanic, aboriginal, African, south Asian)
Hx GDM
Delivery of macrosomic infants
Acanthodii’s nigricans
PCOS
Vascular disease

Question 2

When do you screen for diabetes

Answer 2

Every 3 years after the age of 40 or sooner if risk factors

Question 3

When do you screen for GDM

Answer 3

Between 24 and 28 weeks

Question 4

What is considered abnormal in screening for GDM vs on the cusp of abnormal and what do you do if it is on the cusp

Answer 4

Abnormal(GDM) - OGCT 50 g >10.3
If OGCT 50 g is between 7.8-10.2 - do the 75 g OGTT

Question 5

Values for diagnosis of diabetes

Answer 5

A1C > 6.5
Fasting glucose > 7 on two occasions
Random glucose of > 11.1

Normal <6.1 on fasting plasma glucose

Question 6

Class of metformin

Answer 6

Biguanide

Question 7

Advantages of metformin

Answer 7

Weight neutral
Decreases chances of hypoglycemia

Question 8

Disadvantages of metformin

Answer 8

GI side effects (diarrhea)
Contraindicated if egfr <30ml/min
Caution if liver failure or egfr <60
Risk of lactic acidosis in Hf, renal or liver disease or hypoxemia