Exam 2 - Diabetes Kania Flashcards
normal UACR (urinary albumin-to-creatinine ratio)
< 30 mg/g
normal eGFR
> 60 mL/min/1.73m2
most common ocular complication of diabetes
retinopathy
for T1DM, have an initial eye exam
a. at time of diabetes diagnosis
b. within 5 years after onset of diabetes
b. within 5 years after onset of diabetes
for T2DM, have an initial eye exam
a. at time of diabetes diagnosis
b. within 5 years after onset of diabetes
a. at time of diabetes diagnosis
treatment for ocular complications
-photocoagulation therapy or anti-vascular endothelial growth factor, ranibizumab
what is a diabetes monofilament test?
test done on the feet to check for nerve damage (peripheral neuropathy)
what 3 drugs are recommended as initial therapy for peripheral neuropathy?
pregabalin
duloxetine
gabapentin
(others: TCAs such as amitriptyline, venlafaxine, carbamazepine, tramadol, capsaicin and tapentadol as last resort) .
what is postural hypotension?
sudden drop in BP and dizziness when you change positions (ex. going from lying down to standing)
leading cause of morbidity and mortality in type 2 diabetes pts
atherosclerotic cardiovascular disease (ASCVD)
ADA BP goal for:
T2DM or T1DM?
DM + pregnancy?
< 130/80 T2DM or T1DM
110-135/85 DM + pregnancy
ACC BP goal for pts with diabetes
< 130/80
(< 140 SBP acceptable for elderly due to fall risk)
ACEIs or ARBs are preferred antihypertensive agents for diabetes management. Use at max tolerated doses, especially for pts with UACR > or equal to _____
300 mg/g
why can’t we use ACEIs or ARBs in combo?
due to risk of hyperkalemia, syncope, and renal dysfunction
CVD risk factors include LDL > or = to _____, HTN, smoking, CKD, albuminuria, and family history of early ASCVD
a. 50 mg/dL
b. 75 mg/dL
c. 100 mg/dL
d. 150 mg/dL
c. 100 mg/dL
DM + ASCVD in all ages = _____ _____ statin therapy + _____
high intensity; LSM
for pts with DM + ASCVD, target lower LDL by > or = ___% and goal LDL < ___
50%; 55
when can we add ezetimibe or a PCSK9 inhibitor for pts with DM + ASCVD?
if LDL elevated despite max tolerated statin dose (goal LDL < 55)
ACC/AHA recommendations for DM pts 40-75 yo: primary prevention
moderate-high intensity statin depending upon risk factors
ACC/AHA recommendations for DM pts 40-75 yo: for secondary prevention, what strength statin would we use, and what is goal LDL level?
high intensity statin and goal LDL < 70
high intensity statin doses (2 of them)
atorvastatin 40-80 mg/day OR rosuvastatin 20-40 mg/day
leading cause of non-traumatic amputations
diabetes
use of antiplatelet agents in pts with diabetes:
-use aspirin (75-162 mg) as _____ prevention in those with diabetes and a history of CVD.
-for pts with CVD and aspirin allergy, use _____
secondary; clopidogrel (75 mg/day)
which pts can we use aspirin (75-162 mg) for primary prevention in pts with diabetes?
men or women 50 or older with one major risk factor who are not at an increased risk of bleeding