Diabetes

Question 0

If DKA, what therapy is required?

Answer 0

Insulin

Question 1

Prediabetes

Answer 1

A1C 5.7-6.4%

Question 2

RF for DM2?

Answer 2

First degree relative
Race (AA, AA, Hispanic, Pacific Islander, Native American)
Overweight (BMI > 25 kg/m2)
Physical inactivity
HTN or taking meds for HTN
HDL < 35 mg/dl and/or TG > 250 mg/dl
History of CVD
A1C _> 5.7%, IGT, IFG on previous testing
Women who delivered baby >9lbs or had GDM
Women with PCOS
Other clinical conditions ass. w. obesity

Question 3

Which drugs can cause hyperglycemia?

Answer 3

Corticosteroids
PI
AAP (olanzapine, clozapine, quetiapine)
Niacin
Thiazides and loop diuretics
Statins
Octreotide (in type 2)
FQ
Beta agonists
Carvedilol, propranolol and possibly other BB
Cyclosporine, tacrolimus
Interferons
Diazoxide (proglycem used for low BG due to certain diseases)
Cough syrups

Question 4

Which drugs can cause hypoglycemia?

Answer 4

FQ
Octreotide (in type 1) 
Propranolol 
Lot assertion (Belviq)
Quinine 
Insulin and insulin secretagogues

Question 5

Without any RF, when should you begin testing for DM?

Answer 5

45 yo

Question 6

Clinical S&S of diabetes

Answer 6

Polyuria
Polyphagia
Polydipsia
Blurred vision
Fatigue

Question 7

Screening recommendations in adults? Children?

Answer 7

Adults: at any age if overweight with one or more RF; if no RF 45 yo

Children: at any age if overweight with 2 or more RF

Question 8

What are the abc’s of diabetes care?

Answer 8

A1c, BP, cholesterol

Question 9

What is the standard of care for GDM?

Answer 9

Nutrition therapy

Question 10

What waist circumference should be maintained for females? Males?

Answer 10

Females < 35 inches; males < 40 inches

Question 11

First line BP agent in diabetic patients?

Answer 11

ACEI or ARB - due to it’s ability to reduce the development or progression of diabetic neuropathy

Question 12

A1C correlation with mean plasma glucose

Answer 12

6-127
7-154
8-183
9-212
10-240
11-269
12-298

Question 13

What is the BP goal in diabetic patients?

Answer 13

<140/80 mmHg

Question 14

What is the cholesterol goal in diabetic patients without overt CVD? With overt CVD?

Answer 14

< 100 mg/dL; < 70 mg/dL

TG < 150 mg/dL

HDL > 40 mg/dL in men; > 50 mg/dL

Question 15

When should statin therapy be initiated in diabetic patients?

Answer 15

1. If overt CVD

2. Without overt CVD but is > 40 yo with one or more CVD RF