L10: Diabetes - Oral meds, Calculation of BMI and target for Asians

Question 1

What is pre-diabetes?

Answer 1

Glycaemic levels that are higher than normal, but lower than diabetes threshold

Question 2

How is one diagnosed with pre-diabetes?

Answer 2

if the patient have IFG/ IGT, or both

impaired fasting glucose
impaired glucose tolerance

Question 3

What is the fasting blood glucose level in pre-diabetes?

Answer 3

6.1-6.9mmol/L (known as impaired fasting glucose, IFG)

pre-diabetes under fasting blood glucose –> impaired fasting glucose

Question 4

important*

What is the fasting blood glucose level for diabetes?

Answer 4

more than 7.0mmol/L

Question 5

What is the blood glucose level of a pre-diabetes, in a two-hour plasma glucose level after glucose tolerance test (OGTT)?

Answer 5

7.8-11.0mmol/L (impaired glucose tolerance, IGT)

pre-diabetes in OGTT –> impaired glucose tolerance

Question 6

important*

What is the blood glucose level of diabetes, in a two-hour plasma glucose level after glucose tolerance test (OGTT)?

Answer 6

more than 11.1mmol/L

Question 7

What is the random blood glucose level for diabetes

Answer 7

more than or equal to 11.1mmol/L

Question 8

What is the HbA1C value for diagonsis of diabetes?

Answer 8

more than or equal to 6.5%

*not used to diagnose diabetes, just how blood glucose is controlled

Question 9

What health risks are pre-diabetic patients exposed to?

Answer 9

• developing type 2 diabetes mellitus
• cardiovascular disease

Question 10

What is the management of pre-diabetes? explain

Answer 10

Lifestyle intervention:
1. Healthy diet
2. Increased physical activity
3. Stop smoking

Question 11

What is the BMI goals for pre-diabetes persons?

Answer 11

<23kg/m2 and/or 5-10% body weight loss

gradually achieved & maintaineed –> a negative calorie balance

Question 12

got 3

What are the recommendations for lifestyle intervention?

Answer 12

1. Increased physical activity –> at least 150mins of moderate activty / 75mins of intense activity every week
2. No more than 2 consecutive days without exercise
3. If patient smokes - quit smoking

Question 13

When to consider use of metformin for persons with pre-diabetes?

Answer 13

1. glycaemic status worsens despite lifestyle intervention
2. unable to adopt lifestyle intervention due to health reasons

Question 14

What is the difference between Type 1 and Type 2 diabetes

Answer 14

Type 1 - body immune system destroys insulin producing beta cells in pancreas –> usually no pancreatic function
Type 2 - Most common, insulin present in low, “normal” or high amounts

Question 15

What are the symptoms of diabetes mellitus?

Answer 15

1. always tired
2. frequent urination
3. sudden weight loss
4. wounds that wont heal
5. sexual problems
6. always hungry
7. blurred vision
8. numb or tingling hands or feet
9. always thirsty
10. vaginal infections

Question 16

What are the risk factors for Diabetes Mellitus

Answer 16

1. overweight: BMI more than or equal to 23kg/m^2
2. obese: BMI more than or equal to 27.5kg/m^2
3. family history of diabetes
4. high risk rase/ethnicity (blacks/hispanics)
5. hypertension more than 140mmHg / on medications for hypertension
6. history of cardiovascular disease
7. women with polycystic ovarian syndrome

Question 17

What are the complications of uncontrolled diabetes?

Answer 17

1. retinopathy (loss of eye sight)
2. nephropathy (kidney damage)
3. heart disease, stroke
4. poor blood flow
5. foot problems and leg ulcers
6. infections
7. impotence in men

Question 18

What is a healthy BMI range?

Answer 18

18.5 to 22.9kg/m^2

Question 19

target!

What are the glycaemic targets for diabetes patients

1. fasting plasma glucose
2. 2 hour post meal glucose
3. HbA1c

Answer 19

1. Fasting plasma glucose (4.0-7.0mmol/L)
2. 2-hour post meal glucose (< 10 mmol/L)
3. HbA1c (< 7.0%)