Correct Answers
C-peptide
What test is done to determine if a patient is still producing insulin?
Very low or absent (undetectable)
How do you diagnose T1DM with C-peptide test?
insulin (preferred; metformin and glyburide are sometimes used)
What medications are preferred in diabetes in pregnancy?
35 years old
When should patients be screened for diabetes?
Diabetes: 6.5% or higher
Prediabetes: 5.7-6.4%
Diagnostic criteria for diabetes and prediabetes (A1c)?
Diabetes: 126 or higher
Prediabetes: 100-125
Diagnostic criteria for diabetes and prediabetes (FPG)?
Diabetes: 200 or higher
Prediabetes: 140-199
Diagnostic criteria for diabetes and prediabetes (OGTT)?
A1c: <7%
Pre-prandial: 80-130
2-hr PPG: <180
Glycemic targets in diabetes (not pregnant)?
Pre-prandial: 95 or lower
1-hr PPG: 140 or lower
2-hr PPG: 120 or lower
Glycemic targets in diabetes (pregnant)?
6% = 126mg/dL
Each additional 1% = 28mg/dL
A1c and eAG (estimated average glucose)
<35 inches (females)
<40 inches (males)
What is the goal waist circumference?
- retinopathy
, - diabetic kidney disease (nephropathy)
- peripheral neuropathy
- autonomic neuropathy (gastroparesis, loss of bladder control, erectile dysfunction)
What are examples of microvascular complications with diabetes?
- CAD (including MI)
- Cerebrovascular disease (including stroke, CVA)
- PAD
What are examples of macrovascular complications with diabetes?
pregabalin, duloxetine, gabapentin
What are some treatment options to treat peripheral neuropathy?
Diabetes + ASCVD
Age 50-75 years + multiple ASCVD risk factors
When is a high-intensity statin indicated in patients with diabetes?
Diabetes + age 40-75 years (no ASCVD)
Diabetes + age <40 years + ASCVD risk factors
When is a moderate-intensity statin indicated in patients with diabetes?
Ezetimibe
What add on therapy can be considered for cholesterol control in diabetic patients when the patients
ASCVD 10-yr risk >20%
Icosapent ethyl
What add on therapy can be considered for cholesterol control in diabetic patients when the patients
LDL is controlled but TGs are 135-499mg/dL
ACE-I or ARB
What medication is recommended in diabetic patients with albuminuria?
SGLT2 inhibitor
(or Finerenone in patients unable to take SGLT2i)
What medication is recommended in diabetic patients with eGFR 25 or more and urine albumin 300
or more?
GLP-1a or SGLT2i
Which medications have been proven benefit at baseline regardless of A1C in patients who have
ASCVD, HF, or CKD?
metformin + non-insulin drug
What should be done at baseline of A1C 8.5-10%
Insulin
What can be started initially if hyperglycemia is severe (A1c >10% or BG 300 or more)?