Diabetes (Slide Deck 2) Flashcards
What is A1C
measure of glycemic control over a defined period of time (the previous 3 months)
What is the process of A1C (MOA kind of)
Glucose attaches to RBCs when present in high levels in the blood, and A1C is the % of hemoglobin A that has been irreversibly glycosylated
The more glucose there is in the blood?
The higher the A1C will be
What is the normal A1C levels?
4-6%
How often should A1C be checked?
every 3 months
What is the target range of A1C for adults with type 2 diabetes with potential for remission to normoglycemia?
<6.0
What is the target range of A1C for adults with type II diabetes to reduce the risk of CKD and retinopathy if at low risk of hypoglycemia?
<6.5
What is the target range for most adults with T1 or T2 diabetes? A1C
<7.0
What circumstances would we have someone with higher A1C targets?
Functionally dependant
Recurrent severe hypoglycemia or hypoglycemia unawareness
Limited life expectancy
Frail elderly and/or with dementia
Why should we typically avoid higher A1C targets?
Hyperglycemia risk
To achieve a A1C of <7.0 what should the preprandial plasma glucose be at?
4.0-7.0
To achieve a A1C of <7.0 what should the 2 hour postprandial plasma glucose level be?
5.0-10.0
Why is a target of less then <7.0 usually achieved for A1C levels?
Any lower higher risk of hypoglycemia, Though some people who are more responsible can manage better
Why would death be associated with lower A1C <6?
Higher chances of hypoglycemia
Lower A1C provides strong ___ to microvascular complications
benefits
How long is the glucose lag seen on the electronic monitors?
THe electronic monitors lag a little more since the capillary glucose must diffuse into the interstitial fluid – which may lag capillary levels by 5 to 15 minutes
What are some of the benefits of using a rtCGM
Sends alerts if outside target range (and before if predicted to go out of range)
Measures glucose every 5
minutes – can access any time
Sensor replaced up to every 10 days (G6) and 7 days (Guardian)
What are some of the benefits of isCGM
Measures glucose every minute and stores readings every 15 min – the data is downloaded after 14 days
Stand-alone system
Applied on back of arm
What causes an increase in ketones primarily?
Ketones usually occur because you are either: not eating enough total calories, going too long between meals, skipping meals/snacks, nauseous, not eating well/throwing up
What is the non-pharmacological treatment of T2DM
Diet, exercise
How do we measure total CHO?
Refer to nutrition facts, subtract the fibre as it cannot be digested
What can alcohol cause in T1dm or T2DM
Delayed hypoglycemia
What are the exercise recommendation for PWD
- ≥150 mins of moderate to vigorous intensity aerobic exercise/week
- Spread over ≥ 3 days/week
- No more than 2 consecutive days of no activity
