Term
|
Definition
2x HbA1c is preferred test (>6.5%)
2x fasting glucose >126
2x Oral glucose >200
Random glucose >200 + sxtoms |
|
|
Term
|
Definition
USPSTF: Screen if BP>135/80
ADA:
If no risk factors, screen after age 45 ever 3 years. Start earlier if patients are overweight and have one or more risk factors:
-physical inactivity
-race (native american, latin american, asian american, african american).
-first deg relative with diabetes
-hypertension
-low HDL and or high triglycerides
-Gestational Diabetes
-PCOS
-Hx of CV disease
-Acanthosis nigrans
-previous impaired FG or IGT |
|
|
Term
| End Organ Damage from Diabetes |
|
Definition
CV disease (CAD or stroke, equivalent risk to previous MI)
(Prolif) Retinopathy and blindness
Glaucoma
Neuropathy (loss of ankle jerk reflexes)
Nephropathy and ESRD |
|
|
Term
| Type 1 vs Type 2 dIabetes |
|
Definition
Type 1: Insulin Insuff (DKA more common)
Type 2: Insulin Resistance (risk of hyperglycemic hyperosmolor state) |
|
|
Term
| Labs to order in Diabetes |
|
Definition
HbA1C (2 times a year if <7, quarterly if therapy is changing)
Assess end organ damage (ECG, diabetic nephropathy)
Monitor side fx of rx (spot almbumin-to-creatinine, serum creatinine. Vit B12 (can be low w metformin))
Other (TSH, fasting lipid, fasting glucose) |
|
|
Term
|
Definition
-Education and Lifestyle
-Glycemic control (HbA1C <7 prevents microvascular)
-BP and lipid control (reduces CV risk)
- Asprin (decrease CV risk, 81 mg, age >40, alt: clopidogrel)
-Eye Care (timely laser photocoagulation prev loss of vision)
-Foot care (daibetic shoes, refer podiatrist, daily inspection etc)
-Flu vaccine and Pneumococcal vaccine (>2 years, revacc >64 years) |
|
|
Term
|
Definition
BP goal <130/80, w lifestyle and antiHTN agents
ACEi or ARBs are preferred initial therapy in diabetes |
|
|
Term
|
Definition
LDL <100 w/o known CVD
LDL < 70 w known CVD using high dose statin
If TG > 200, target non-HDL cholesterol |
|
|
Term
|
Definition
| Immunologic dz vs pancreatic beta cells (not produce insulin) |
|
|
Term
|
Definition
| Insulin resistance and eventual beta cell dysfunction. |
|
|
Term
|
Definition
| glucose > 250, ph <7.3, dehydration, ketones |
|
|
Term
|
Definition
| Hyperglycemic Hyperosmolar State: glucose >300, ph>7.3, dehydration, no ketones (or minimally elevated) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| respect to elders/authority figures |
|
|
Term
|
Definition
| value warm friendly relationships |
|
|
Term
|
Definition
|
|
Term
|
Definition
| may not accept that thinner is healthier - approaching from balance perspect may help |
|
|
Term
|
Definition
| templates improve care, can evaluate care, improves reimbursements |
|
|
Term
|
Definition
1- Eye Exam (refer to opthalm)
2- Foot Exam
3- Other: Thyroid, Heart, Lungs, Pedal Edema, Skin (Acanthosis N.) |
|
|
Term
| Diabetic Foot Exam - 3 components |
|
Definition
1. Protective Sensation (Monofilament + 128Hz/pinprick/anklereflexes)
2.Pedal Pulses
3.Inspection |
|
|
Term
|
Definition
| HbA1c, EKG(baseline), Spot albumin/Cr(annually), Serum B12(if neuropathy), TSH(annually), Fasting Lipid Profile(dx, 3 mo, Fingerstick Blood sugar |
|
|
