Endo & Metabolic Disorders

Question 1

overall goals of diabetes management (prevention of what?)

Answer 1

_{Blood pressure control and lipid management are important to <strong>reduce the risk of macrovascular complications</strong> such as heart attack and stroke. Glycemic control and blood pressure management <strong>reduce the risk of microvascular complications </strong>(neuropathy, nephropathy, retinopathy).}

_{A primary goal of care is treatment of cardiovascular risk factors with <strong>antihypertensive agents, statins, aspirin</strong> for patients with known coronary heart disease or those at high risk; <strong>ACE inhibitors</strong> for patients with proteinuria; and smoking cessation, to achieve individualized targets.}

_{<strong>Lifestyle changes plus metformin</strong> are initial antihyperglycemic therapy for most patients. Glycemic goals and treatment choices are individualized.}

Question 2

diabetes BP target

Answer 2

<140/90 mmHg

Question 3

Preferred drug treatment regimens for BP control in people with diabetes

Answer 3

ACE inhibitor, angiotensin-II receptor antagonist, calcium-channel blocker, and/or a thiazide diuretic. Black people may begin with a thiazide diuretic or a calcium-channel blocker. ACE inhibitors may reduce mortality and cardiovascular events more than angiotensin-II receptor antagonists.

Beta-blockers are not contraindicated in people with diabetes but are less-preferred antihypertensive agents and may mask symptoms of hypoglycemia.

Question 4

lipd control in people with diabetes

Answer 4

high-intensity statins are recommended for people with diabetes ages 40 to 75 years if the estimated 10-year ASCVD risk is ≥7.5%; otherwise, moderate-intensity statins are recommended

Question 5

Antiplatelet therapy for people with diabetes

Answer 5

The ADA recommended that aspirin therapy be considered for primary prevention in adults with type 2 diabetes with a 10-year cardiovascular risk >10%.

Clopidogrel (Plavix) 75mg daily is an alternative for patients with aspirin allergy or intolerance.

Question 6

hypoglycemia (glucose <70 mg/dL) symptoms

Answer 6

tachycardia, sweating, shakiness, intense hunger, or confusion