Exam 3: Diabetes pt 1

Question 1

FBG ADA target

Answer 1

80-130 mg/dL

Question 2

Postprandial (1-2 hours after meal) BG ADA target

Answer 2

<180 mg/dL

Question 3

Target bedtime glucose

Answer 3

90-150 mg/dL

Question 4

When to do self-monitoring blood glucose tests: Intensive insulin, basal, and non-insulin

Answer 4

Intensive: Prior to meals and at bedtime; prior to snacks/activity; postprandially; suspicion of hypoglycemia and after tx

Basal and non insulin medications: once daily First thing when they wake up

Non-insulin: PRN

Question 5

CGM metrics

Answer 5

(Time above range, time in range, time below range)

TARA >250mg/dL:
Goal reg: <5%
Goal high risk hypoglycemic: <10%

TAR 181-250 mg/dL:
Goal reg: <25%
Goal high risk hypoglycemic: <50%

TIR: 70-180 mg/dL
Goal reg: >70%
Goal high risk hypoglycemic: >50%

TBR: 54-69 mg/dL
Goal reg: <4%
Goal high risk hypoglycemic: <1%

TBR <54mg/dL
Goal reg: <1%
Goal high risk hypoglycemic: 0%

%of time device is active 70%

Question 6

Glycosylated hemoglobin (A1C or HbA1C) definition

Answer 6

non-enzymatic irreversible glycosylation of hemoglobin A circulating in blood; amount formed is related to degree of hyperglycemia

Question 7

Normal A1C

Answer 7

4-6%
Reflects avg. BG concentration over the past 8-12 weeks

Question 8

ADA A1C target

Answer 8

<7% (consider <6% in individual patients and pregnant women)

Question 9

AACE target forA1C

Answer 9

<6.5%

Question 10

Estimated Average Glucose (eAG) (mg/dL) based on A1C

Answer 10

6% - 126
7% - 154
8% - 183
9% - 212
10% - 240
11% - 269
12% - 298

Question 11

Advantages of A1C

Answer 11

Can be measured without fasting
Levels are not subject to acute changes in insulin dosing, exercise, or diet

Question 12

Disadvantages of A1C

Answer 12

DOES NOT REPLACE SMBG or CGM
AVERAGE OF ALL NUMBERS

Conditions that affect RBC turnover may impact results

Question 13

When to measure A1C

Answer 13

Twice a year if meeting tx goals

Quarterly if therapy has changed or not meeting tx goals

FIX FASTING FIRST FOR PEOPLE WHO HAVE ELEVATED A1C

Question 14

Post-Prandial Glucose (PPG) readings

Answer 14

as patients start to achieve tighter control, they need to assess some PPG readings in addition to FPG and utilize meds which impact PPG for tx

Question 15

Monitoring tests

Answer 15

Urine
-Glucose
-Ketones
-Protein
-Microalbuminuria

Others:
-BUN/SCr
-FLP
-BP
-Electrolytes