Lecture 3 - Intro to Clinical Diabetes

Question 1

Patients with Diabetes will typically show a fasting glucose of greater than ____g/dL.

Answer 1

126g/dL

Question 2

Vitamins ___ and ___, as well as Pregnancy and HIV treatment, can FALSELY lower HbA1c.

Answer 2

C and E

Question 3

For which type of diabetes does screening make sense?

US Preventative Services Task Force recommends screening for overweight patients starting at age _____.

ADA recommends annual screening starting at age _____ for all patients (earlier if they have risk factors.)

Answer 3

Type 2

40

45

Question 4

A random glycemic reading of over _____g/dL is diagnostic of diabetes if symptoms of hyperglycemia are present (polyuria. polydipsia, etc…)

Answer 4

200g/dL

Question 5

Screening for gestational diabetes is conducted as a ___-step ____g non-fasting glucose challenge followed by _____g fasting glucose challenge if previous was positive. If the patient has risk factors for gestational diabetes, screen in the ____ trimester. Screen after ____ weeks if no risk factors.

What age is considered a risk factor?

Answer 5

Two-step

50g

100g

1st trimester

24 weeks

35+

Question 6

Pediatric patients (< 18y/o) should be screened for diabetes if they have BMI >____ percentile AND 2 or more risk factors. These patients should be screened every ___ years starting by age _____ or onset of puberty.

Answer 6

BMI > 85th percentile

2 years

10

Question 7

The insulin released by glucose pumps is all ____-acting, but since it is released with mealtime boluses, it more closely simulates natural insulin levels.

Answer 7

Short-acting

Question 8

Main contraindications for Metformin are Kidney failure defined by GFR < ____-____) and/or side effects of ______/______.

Answer 8

30-45

Nausea/Vomiting

Question 9

HbA1c should be checked every _____ months in unstable diabetics (twice per year if stable).

If A1c > ___% –> consider dual therapy.

If A1c > __-__% –> consider metformin + insulin.

Answer 9

3 months

9%

10-12%

Question 10

Target postprandial blood glucose for diabetics is < ____-____g/dL. Target A1c is typically < ___%.

Hospitalized patients should receive insulin if their glucose is persistently > _____g/dL.

Answer 10

140-180g/dL

7% (range between 6.5-8% depending on circumstance/patient)

180g/dL