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Clinical Guidelines > Diabetes Canada > Flashcards

Diabetes Canada Flashcards

1
Q

When to screen for diabetes in people without additional risk factors

A

40 years and older

every 3 years

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2
Q

5 Diabetes risk factors

A 
Family history/1st degree relative w/ type two diabetes
High risk population/non-white/low SES
Hx of gestational diabetes/ prediabetes
CVS risk factors
Presence of end organ damage
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3
Q

In people with diabetes risk factors, when do you screen?

A

screen Q6 to 12 months

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4
Q

FPG <5.6 mmol/L

HgA1C = 5.5%

A

Normal result

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5
Q

FPG 6.1-6.9 mmol/L

HgA1C 6.0-6.4%

A

Impaired fasting glucose

Pre diabetes

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6
Q

FPG 7.0 mmol/L

HgA1C = 6.5

A

Diabetes

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7
Q

List the ABCDES3 of diabetes management

A 
A1C target
BP control
Cholesterol
Drugs to protect heart
Exercise
Screening
Smoking cessation
Self management
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8
Q

What is the most ideal hgb A1C target in the general population

A

= 6.5

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9
Q

What is the general blood pressure target and diabetes management

A

<130/80

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10
Q

What is the general cholesterol target in Dbts mgmt?

A

LDL<2.0 or >50% reduction

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11
Q

In functionally dependent adult what is the A1c target

A

7.1-8.0%

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12
Q

In the frail elderly/with dementia what is the A1c target

A

7.1-8.5%

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13
Q

Blood sugars within what time frame account for 50% of hgb A1c

A

Last 30 days

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14
Q

Iron deficiency anaemia can do what to HgA1C readings?

A

Falsely elevate

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15
Q

What are the general preprandial and postprandial blood sugar targets

A

Pre- 4-7

Post- 5-10

If not at target, may reduce post to 5-8

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16
Q

If HgbA1C is <1.5% above target- next step?

A

Discuss lifestyle Adjustments and reassess at 3 months

If still note at target- start/ increase metformin

17
Q

If HgbA1C >/= 1.5% above target- next step?

A

Start metformin + other antihyperglycemic agent

18
Q

If patients present and are symptomatic of hypo or hyper glycaemia upon initial evaluation, what are the steps taken

A

Insulin +/- metformin

19
Q

What class of antihyperglycemic agent medication show cardio protective benefit

A

SGLT2 - Empagliflozin, ConAgliflozin

GLP1- liraglutide, semaglutide

20
Q

What is the typical starting dose of basal insulin and up titration

A

10 units

Increase 1 unit / day

21
Q

When patients are not meeting HgbA1C Targets, the goal is to correct within——-

A

3-6M

22
Q

What to medication’s are indicated with an eGFR of 15

A

Linagliptin

Liraglutide

23
Q

When/ in whom is Statin therapy started (5 crit)

A 
Clinical CVD
>/= to 40 years
Microvascular complications
DM >15yrs and >30yrs old
Indicated as per dyslipidaemia guideline
24
Q

When initiating ACE/ARB- what does follow up look like?

A

Check Cr and K at baseline and 1-2 weeks after starting.

Assess hyperkalemia and stop if Cr increases 30%

25
Q

What diabetics are started on ACE/ARBs

A

Clinical CVD
Age >/= 55y with additional risk factor or
end organ damage (albuminuria, retinopathy, LVH)
Or macrovascular complication

26
Q

Is starting ACE/ARB therapy in diabetics dependent on BP?

A

No!

27
Q

ASA Is indicated in what form of prevention in diabetes

A

Secondary

28
Q

Physical activity recommendations and diabetes

A

150 min of moderate to vigerous exercise / week

Resistance training 2x/ week

29
Q

Recommended diets in diabetes

A

Vegan/ vegetarian
Medeteranean
DASH
Portfolio

30
Q

People with type two diabetes are screened for retinopathy at diagnoses and——-

A

If negative every 1-2 years

31
Q

In people with type 1 diabetes when to screen for retinopathy?

A

5 years after diagnosis if older than 15years

If negative- anual screening

32
Q

When are diabetics evaluated for chronic kidney disease

A

Urine ACR done at diagnosis and anually

33
Q

How is chronic kidney disease diagnosed and diabetics?

A

Urine ACR > 2.0 ng/ mmol or eGFR < 60ml/min

Require 2/3 results over 3 months

34
Q

How often are patients screened for neuropathy

A

Annually

via 10 g monofilament test

35
Q

ECGs are done and baseline and repeated at 3-5 year intervals in who?

A 
>40 yrs
OR—
Dbts >15 yrs and >30y/o
End organ damage
> 1 CVD risk factors = smoking/ HTN/ Fam hx/ CKD/ Obesity/ Erectyle Dysf/ heart dx
36
Q

Teachings pts about driving-

A

Dont drive with BG <4.0mmol/L

Wait 40 mins after treating and until BG atleast 5.0mmol/L

37
Q

Medications included in SADMANS

A 
Sulfonyureas/ secreragogues
ACE-inhib
Diuretics
Metformin
ARBs
NSAIDS
SGLT2 inhib

Clinical Guidelines (1 decks)

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