PREDIABETES Flashcards
These are all signs of what diagnosis?
- impaired fasting glucose (100-125mg/dL)
- borderline Hgb-A1C elevation (5.7-6.4%)
- 2 hour post-prandial glucose (140-199mg/dL)
Prediabetes
The below is involved in the pathogenesis of what?
- Insulin resistance (insulin receptors on muscle cells do not adequately respond)
- Insulin production is decreasing due to autoimmunity (type 1 diabetes) or decreased insulin production (as seen late in the course of type 2 diabetes and referred to as “pancreatic burnout”)
Prediabetes
These are all risk factors for what?
- family history/genetic predisposition
- obesity
- diet
- physical inactivity
- Race (AA, latino, Native american, asian american, pacific islander)
- women who delivered a baby weighing 9 pounds or greater or had previous diagnosis of gestational diabetes
Prediabetes
True or False
Glucose elevations seen in prediabetes generally will not produce polyuria or polydipsia as seen in Diabetes type 1or 2
True
Patients with prediabetes are generally asymptomatic but it is postulated that early sensory nerve toxicity occurs in prediabetes, producing presenting symptoms such as what?
subtle lower extremity paresthesia
Can patients who forget to fast cause test results to become obscured enough to show signs of prediabetes?
Yes
What is a syndrome that involves excessive cortisol which can be a differential diagnosis of Prediabetes?
Cushings syndrome
What are some medications that may explain a differential diagnosis when concerned for prediabetes?
- corticosteroids
- antibiotics
- beta-blockers
- psychiatric medications
- thiazide diuretics (HCTZ or Chlorthalidone)
Is an increase in physical activity, exercise, and weight loss if overweight or obese an appropriate treatment for prediabetes?
Yes
Prediabetes
In obese patients there is an evidence that Metformin 850mg BID may lower the risk of developing type 2 diabetes by what percentage; but is less effective in thin or older patients?
30%
