Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Diabetes Disease State > Treatment Overview: ADA, AACE, DCCT, UKPDS > Flashcards

Treatment Overview: ADA, AACE, DCCT, UKPDS Flashcards

1
Q

An A1c test measure average plasma glucose over the previous ___ to ___ months.

A

2-3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How often should an A1c be tested in a patient with good glycemic control?

A

twice yearly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How often should a patient have an A1c test done if their therapy has recently been changed or who are not meeting treatment goals?

A

once every quarter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the ADA goals for preprandial glucose and postprandial glucose?

A
  • Preprandial: 70-130 mg/dL
  • Postprandial: <180 mg/dL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the ADA targets for blood pressure?

A

<130/80 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the ADA targets for lipids? (LDL, triglycerides, HDL)

A
  • LDL: <100 mg/dL
  • Triglycerides: <150 mg/dL
  • HDL: >40 mg/DL (men), >50 mg/dL (women)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the AACE goals for preprandial and postprandial glucose?

A
  • Preprandial: <110 mg/dL
  • Postprandial: <140 mg/dL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What was DCCT stand for?

A

Diabetes Control and Complications Trial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What patient population did the DCCT study?

A

type 1 patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What did the DCCT compare?

A

type 1 patients who were either managed with intensive insulin therapy (3 or more injections per day) or with a more conventional regimen (1-2 insulin injections per day)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What was a key finding of the DCCT?

A

Any reduction in A1c is helpful in preventing or reducing the complications of type 1 diabetes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What was the potential adverse effect(s) associated with intensive insulin therapy according to the DCCT?

A
  • intensive therapy had a 2-3 fold greater incidence of severe hypglycemia.
  • weight gain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

According to the ADA, what should the treatment regimen be in every newly diagnosed type 2 patient?

A

lifestyle changes and metformin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does UKPDS stand for?

A

United Kingdom Prospective Diabetes Study

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What group of patients did UKPDS study?

A

type 2 patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How many patients were in the UKPDS?

A

3,867

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How long were patients in the UKPDS followed?

A

10 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What was the purpose of the UKPDS?

A

to compare patients who were randomized to conventional therapy (diet alone) or intensive therapy (managment with 1 or more pharmacologic agents, including insulin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What was the median A1c at the end of the trial for patients in the conventional arm versus the intensive arm?

A

7.9% for conventional, 7.0% for intensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Compared to conventional therapy, intensive therapy reduced microvascular complications (retinopathy, nephropathy, neuropathy) by _____%.

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

According to UKPDS, for every ____% decrease in A1c achieved there was a _____% decrease in the risk of microvascular complications.

A

1% decrease, 35% decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

In UKPDS, there was a nonsignificant trend toward a reduced risk of ________________ with intensive therapy.

A

myocardial infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

True or False: UKPDS found that strict blood pressure control produced even greater benefits than glycemic control.

A

True.

24
Q

What is the primary limiting factor in intensive regimens?

A

hypoglycemia

25
Q

What did the DAWN study report?

A

there were low levels of compliance with self-management behaviors

26
Q

What does MNT stand for?

A

Medical Nutrition Therapy

27
Q

What is the average minimum requirement of carbohydrates per day for most people?

A

130 g

28
Q

According to proper MNT, saturated fats should be limited to <____% of total calories.

A

7%

29
Q

Dietary cholesterol should be limited to <_____ mg/day.

A

<200 mg per day

30
Q

The protein recommendation for patients with normal renal function is __% - __% of total calories, which is the same recommendation for the general population.

A

15%-20%

31
Q

For patients in the early stages of chronic kidney disease, what should their level of protein intake be?

A

0.8-1.0 g/kg of body weight per day

32
Q

True or False: Protein can increase insulin sensitivity in patients with type 2 diabetes without increasing plasma glucose.

A

True. Therefore, protein should not be used to prevent or treat nocturnal hypoglycemia.

33
Q

How much exercise does the ADA recommend each week?

A
  • at least 150 minutes of moderate-intensity aerobic exercise per week spread out over at least 3 days per week iwth no more than 2 consecutive days without exercise.
  • resistance exercise at least twice per week
34
Q

What are the symptoms of hypoglycemia?

A
  • shakiness
  • weakness
  • confusion
  • fatigue
  • irritability
  • rapid pulse rate
35
Q

What did DECODE study show regarding correlation between age and hyperglycemia?

A

postmeal hyperglycemia increases with age

36
Q

Diabetes increases the risk for adverse coronary events ___fold in women and ___fold in men.

A

twofold (women), fourfold (men)

37
Q

Hypertension in type 1 patients is often due to underlying _________________.

A

nephropathy

38
Q

Hypertension in type 2 patients is often part of _____________ and ____________.

A

hyperglycemia, dyslipidemia

39
Q

What are the blood pressure treatment goals for adults with diabetes?

A

<130mmHg / <80mmHg

40
Q

Patients with more severe hypertension should receive pharmacologic therapy. When should therapy be initiated?

A

=>140 mmHg / =>90 mmHg

41
Q

What is the first-line agents for BP lowering in diabetes patients? Why?

A

ACE inhibitors and ARBs because they have been shown to slow the development of nephropathy

42
Q

What are the lipid abnormalities associated with type 2 diabetes?

A
  1. high triglycerides
  2. low HDL
  3. high LDL
43
Q

How often should lipid panels be done in adult patients?

A

at least every year unless part of a low-risk group (then every 2 years)

44
Q

In individuals without overt CVD, what is the primary goal of lipid control?

A

reduce LDL levels (goal is <100 mg/dL)

45
Q

In individuals with overt CVD, what is the LDL goal?

A

<70 mg/dL

46
Q

What is the secondary goal of lipids management?

A
  • lower triglycerides to <150 mg/dL
  • raise HDL to >40 mg/dL (men) and >50 mg/dL (women)
47
Q

What is the most frequent cause of new blindness among adults ages 20-74?

A

diabetic retinopathy

48
Q

True or False: nearly all type 1 patients develop retinopathy during the first 2 decades of diabetes.

A

True.

49
Q

According to the ADA, how often should type 1 patients aged 10 years or older received a dilated and comprehensive eye exam?

A

within 2-5 years of diagnosis and annual exams thereafter

50
Q

All women with diabetes who plan on becoming pregnant should have an eye exam when?

A

before conception and within the first trimester and for 1 year postpartum

51
Q

What percentage of new ESRD is attributed to diabetes?

A

40%

52
Q

About __% to __% of patients with diabetes develop nephropathy.

A

20%-40%

53
Q

How is nephropathy usually first detected?

A

as small amounts of protein in the urine (microalbuminuria)

54
Q

How often should urine be screened for albumin?

A
  • at the time of diagnosis for type 2 patients
  • 5 years after diagnosis for type 1 patients
  • subsequent screening should occur annually
55
Q

How many abnormal tests are required to designate a patient as having microalbuminuria?

A

2 out of 3 over a 3-6 month period

Diabetes Disease State (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions