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Guidelines > Diabetes CPG > Flashcards

Diabetes CPG Flashcards

1
Q

Antibodies noted on Type 1 DM patients

A

ICA positive

Anti-GAD positive

ICA 512 positive

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2
Q

Testing should be considered in all adults of what age?

A

> /= to 40

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3
Q

What is the weigh circumference threshold for testing for DM for males and for females

A

Females >/= 80 cm
Males >/= 90 cm

Waist to hip ratio

>/= 1 for males
>/= 0.85 for females
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4
Q

Disease conditions with strong corelation with DM

A

PCOS
IGT
IFG
GDM

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5
Q

If initial screening for DM is negative repeat screening should be done how often?

A

Anually

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6
Q

FBS criteria for diagnosis of DM

A

> 7 mmol/L or

>126 mg/dL

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7
Q

How long should the patient fast for an FBS?

A

8-14 hours

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8
Q

What is the DM criteria for 75 gram OGTT

A

> /= 200 mg/dL

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9
Q

What is the DM criteria for RBS

A

> /= 200 mg/dL

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10
Q

If Tests are positive but the individual is asymptomatic repeat testing should be done when?

A

In two weeks time

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11
Q

75 gram OGTT is preferred for the following individuals

A

IFG

Previous CVD/ high risk CVD patient

Metabolic Syndrome

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12
Q

Criteria for Pre - Diabetes

A
  1. FBS 5.6 - 6.9

75 gram OGTT = 140- 199

RBS 140 - 199

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13
Q

Criteria for Normal blood sugar

A

FBS <5.6 mmol/L

RBS and 75 gram OGTT <7.7 or 150 mg/dL

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14
Q

At what AOG is fetal cell responsive to maternal glucose load?

A

16th week AOG

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15
Q

Routine testing for GDM should be done at what AOG?

A

24-28 weeks AOG

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16
Q

How do you interpret the 75 gram OGTT?

A

Based on IADPSG
FBS 92
1 hr 180
2 hrs 153

ADA
FBS 95
1 hour 180
2 hours 155
3 hours 140
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17
Q

When is a repeat 75 gram OGTT requested for GDM patients?

A

6-12 weeks post Partum

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18
Q

Examples of Microvascular complications of DM?

A 
Retinopathy
Neuropathy
Nephropathy
Autonomic
Sexual dysfunction
Gastroparesis
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19
Q

Macrovascular

A

Stroke
CAD
PVD

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20
Q

Cut-off for overweight Asians

Cut off for obese Asians

A

23 kg/m2

25 kg/m2

21
Q

When is eye exam done for type 2 DM?

A

Immediately upon diagnosis

22
Q

Required laboratories requested for patients with Dm?

A

FBS
lipid profile
Hba1c
Liver enzyme

23
Q

Laboratory parameter that is a known predictor of complications?

A

Hba1c

24
Q

What laboratory parameter is being targeted?

How often do you monitor it?

A

Hba1c reduction is the aim

Every 3-6 months

25
Q

Target glycemic control for Hba1c?

A

<7%

26
Q

CBG target pre meals?

CBG target post meals?

A

90-130 mg/dL

<180 mg/dL

27
Q

Glycemic control should be achieved within how many months after initiation of therapy?

A

Within 6 months of Diagnosis/ initiation of therapy

28
Q

BP target for diabetic patients

A

Generally <140/80

Young, less co morbids <130 mmHg

29
Q

Lipid profile target for diabetic patients?

A

LDL

30
Q

Statin therapy is initiated regardless of lipid levels for what group of patients?

A
  1. CVD
  2. > 40 with one or more risk factor for CVD

For <40 patients start statin therapy if LDL is >100mg/dL

31
Q

LDL target for patients with overt CVD

LDL target for those without overt CVD

A

Overt CVD <70 or <1.8 mmol/L

Without overt CVD <100 or <2.6 mmol/L

32
Q

If max dose of statin is being used and the patient has side effects what percent is the appropriate reduction?

A

30-40%

33
Q

Aspirin therapy at 75-162 mg/day is used for high risk patients.

A

Men >50

Women >60

With hypertension
Smoking
Dyslipdemia
Albuminuria
Family Hx of CVD
34
Q

Weight target for patients with DM

A

0.5-1 kg/wk or 1-2 lbs/week

35
Q

Macronutrient proportion for DM patients

A

50-55 % CHO

30% fat

15- 20% protein

36
Q

For DM patients salt intake should be limited at?

A

< 6 grams/ day

37
Q

Moderate physical activity is how many METs

A

3-6 METs

38
Q

Moderate intensity is how many percent of max HR?

A

50-70%

Max HR is 220-Age

39
Q

How do you treat a patient with

Hba1c < 8

FBS <140

RBS <200

A

Life style therapy with or without metformin

Recheck after 3 months

40
Q

Drug classification of metformin?

A

Biguanides

Action - decreases hepatic glucose production
- increases inuslin sensitivity

41
Q

Thiazolidinediones stimulate what receptor?

A

PPAR gama receptors

E.g. Pioglitazone

42
Q

DPP4 inhibitors MOA and Example

A

MOA - inhibits DPP4 to increase GLP - 1
GLP-1 increases insulin secretion

E.g. gliptins

43
Q

This drug class acts on the distal collecting tubules to prevent glucose reabsorption

A

SGLT2 inhibitors

empaglifuzin

44
Q

Drug class contraindicated for Heart Failure patients

A

Thiazolidinediones

45
Q

Regular insulin

Onset of Action?

Peak?

Duration?

Examples?

A

Onset of Action? 0.5-1 hr

Peak? 2-4 hrs

Duration? 6-8 hrs

Examples? Humulin R, Actrapid

46
Q

Rapid acting analogues (Lispro, Aspart, Glulisine)

Onset of Action?

Peak?

Duration?

Examples?

A

Onset of Action? 10-15 minutes

Peak? 1 hr

Duration? 3-4 hrs

Examples? Humalog, novorapid, Apidra

47
Q

NPH - intermediate acting inuslin

Onset of Action?

Peak?

Duration?

Examples?

A

Onset of Action? 1-3 hrs

Peak? 6-8 hrs

Duration? 12-16 hrs

Examples? Humulin N, Insulitard

48
Q

Glargine, Detrimir

Onset of Action?

Peak?

Duration?

Examples?

A

Onset of Action? 1-2 hrs

Peak? Flat no peak

Duration? 24 hours - glargine
16-24 hours detrimir

Examples? Lantus, levemir

Guidelines (5 decks)

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