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Questions and Answers
What factors can contribute to the preservation of beta-cell function in diabetes management?
What factors can contribute to the preservation of beta-cell function in diabetes management?
What is a potential outcome of uncontrolled diabetes over time?
What is a potential outcome of uncontrolled diabetes over time?
Which of the following glucose levels indicates pre-diabetes according to the given content?
Which of the following glucose levels indicates pre-diabetes according to the given content?
What is a common way to diagnose diabetes according to the provided information?
What is a common way to diagnose diabetes according to the provided information?
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What does increased insulin resistance imply for individuals with diabetes?
What does increased insulin resistance imply for individuals with diabetes?
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What does a fasting glucose level above normal indicate?
What does a fasting glucose level above normal indicate?
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What is the significance of pre-diabetes conditions like IFG and IGT?
What is the significance of pre-diabetes conditions like IFG and IGT?
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What does the term 'insulin resistance' refer to in the context of Type 2 Diabetes?
What does the term 'insulin resistance' refer to in the context of Type 2 Diabetes?
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How does post-meal glucose level relate to Type 2 Diabetes?
How does post-meal glucose level relate to Type 2 Diabetes?
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Why might a person with high blood sugar levels feel well?
Why might a person with high blood sugar levels feel well?
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What is considered a fasting plasma glucose level for diagnosing diabetes?
What is considered a fasting plasma glucose level for diagnosing diabetes?
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Which HbA1c level indicates diabetes diagnosis?
Which HbA1c level indicates diabetes diagnosis?
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What is the recommended procedure for confirming a diabetes diagnosis?
What is the recommended procedure for confirming a diabetes diagnosis?
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What glucose level after a 75g Oral Glucose Tolerance Test (OGTT) indicates diabetes?
What glucose level after a 75g Oral Glucose Tolerance Test (OGTT) indicates diabetes?
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What is the classification of blood glucose under 5 mmol/L fasting?
What is the classification of blood glucose under 5 mmol/L fasting?
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During which condition are hyperglycemic emergencies a concern?
During which condition are hyperglycemic emergencies a concern?
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What does HbA1c represent in diabetes management?
What does HbA1c represent in diabetes management?
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What blood glucose level is diagnostic for random plasma glucose measurement for diabetes?
What blood glucose level is diagnostic for random plasma glucose measurement for diabetes?
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What are the primary aims of diabetes treatment?
What are the primary aims of diabetes treatment?
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Which of the following is considered a microvascular complication of diabetes?
Which of the following is considered a microvascular complication of diabetes?
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What is a suitable target range for pre-meal blood glucose levels for diabetes management?
What is a suitable target range for pre-meal blood glucose levels for diabetes management?
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Which of the following factors should be considered when establishing HbA1c targets with patients?
Which of the following factors should be considered when establishing HbA1c targets with patients?
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What should be emphasized in lifestyle treatment for diabetes?
What should be emphasized in lifestyle treatment for diabetes?
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Which diabetic emergency is characterized by abnormally low blood sugar levels?
Which diabetic emergency is characterized by abnormally low blood sugar levels?
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What is one of the key assessments in diabetes management?
What is one of the key assessments in diabetes management?
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What is the essential monitoring test for assessing long-term diabetes control?
What is the essential monitoring test for assessing long-term diabetes control?
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Study Notes
Role of the Endocrinologist
- Focus on managing hormonal imbalances.
- Conditions include diabetes mellitus, obesity, thyroid disorders, and osteoporosis.
Diabetes Overview
- Defined by the body's inability to regulate blood glucose.
- Diagnosis classifications include Type 1, Type 2, and gestational diabetes.
Diagnosis of Diabetes
-
American Diabetes Association (ADA) Criteria:
- Fasting plasma glucose: ≥7.0 mmol/L
- 2-hour plasma glucose after 75g OGTT: ≥11.1 mmol/L
- Random plasma glucose: ≥11.1 mmol/L
- HbA1c: ≥6.5% (confirmed with repeat testing).
Pathophysiology
- Type 2 diabetes involves insulin resistance and progressive beta-cell dysfunction.
- Glucose levels and insulin secretion decline over years, often presenting with prediabetes stages (IFG, IGT).
Complications of Diabetes
- Acute Complications: Hypoglycemia, hyperglycemic emergencies, infections.
-
Chronic Complications:
- Macrovascular: ischemic heart disease, stroke, peripheral arterial disease.
- Microvascular: retinopathy, nephropathy, neuropathy.
- Effective diabetes management preserves beta-cell function and prevents complications.
Outpatient Management
- Emphasis on comprehensive history-taking including:
- Duration of diabetes and control metrics (HbA1c).
- Family history and previous complications.
- Lifestyle interventions: diet, exercise, weight loss.
- Pharmacological treatments: oral medications or insulin.
Treatment Goals
- Short-term: Relieve symptoms of hyperglycemia.
- Long-term: Prevent micro and macrovascular complications.
Physical Examination
- Monitor height, weight, BMI, blood pressure.
- Skin examination for signs like acanthosis nigricans and check insulin injection sites.
- Foot examination for ulcers and neuropathy through sensation testing.
Self-Monitoring of Blood Glucose
- Goals for pre-meal glucose: 4.4-7.2 mmol/L.
- Post-meal glucose targets should be established.
Inpatient Management
- Recognize and treat hyperglycemic emergencies and hypoglycemia promptly.
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