Final Exam NR 601 Study guide Marking
Scheme
DM1 definition patho - ANS-or absence of functioning beta cells
Autoimmune disorder
Asymptomatic diabetes - ANS-type II diabetes affects nearly 10% of the population, and
due to this high prevalence, potentially severe complications
Prediabetes labs - ANS-1. Prediabetic- fasting glucose consistently elevated above the
normal range but less than 100-125.
Impaired glucose tolerance (IGT) state of hyperglycemia where 2 hr post glucose load
glycemic level is 140-199.
RANDOM glucose test cannot be used to diagnose pre-diabetes. Needs to be fasting or
two-hour glucose tolerance test. A1c greater than 5.7%. Fasting blood glucose greater
than 100 but less than 126. OGTT greater than 140 but less than 200.
Diagnostic Criteria of Diabetes - ANS-However, if the individual is asymptomatic, then a
diagnosis of diabetes mellitus requires two positive tests that are separated by at least
one week of time.
Diagnostic Criteria - ANS-· AIC of 6.5 or higher=diabetes
· Random plasma glucose level of 200 WITH classic symptoms of hyperglycemia or a
hyperglycemic crisis
· Fasting plasma glucose level of 126 or higher on TWOoccasions(fasting is defined as
no caloric intake for at least 8 hrs
· 2 hour glucose tolerance test- 2-hour post load plasma glucose level of 200 or higher
during an OGTT, following consumption of a glucose load containing the equivalent of
75g of anhydrous glucose dissolved in water (OGTT is also used to screen for diabetes
during pregnancy)
screening for type 1 and type 2 - ANS-· You do not screen for type 1 diabetes but you
do screen for type 2 if an individual is overweight or obese, regardless of age, and for all
adults aged 45 years and older. Tests should be repeated at a minimum of 3 year
, intervals
what is the minimum time interval for screening for Diabetes type 2 - ANS-3 years
treatment for Type 1
and what blood sugar level before meals? - ANS-Type 1- FIRST LINE: INSULIN. The
initial goal of treatment for type 1 DM is to normalize the elevated blood glucose level.
This is best accomplished by intensive insulin regimens to achieve the following goals:
plasma glucose levels of 80 to 130 mg/dL before meals
1 - 2 hours postprandial blood sugar
and A1C goal for a type 1 DM? - ANS-(1-2 hours after the beginning of a meal) glucose
levels of less than 180 mg/dL, and an A1C below 7% for adults with type 1 DM.
initiation of insulin therapy - ANS-. INITIATION OF INSULIN THERAPY IN NEWLY
DIAGNOSED TYPE 1 DM, SHOULD BE MANAGED BY OR IN CLOSE
COLLABORATION WITH AN ENDOCRINOLOGIST.
DM 2 Management - ANS-Type 2-FIRST LINE: LIFESTYLE MANAGEMENT
metformin
is first line medication management
when is a second medication added??? - ANS-The AACE recommends adding a
second agent to lifestyle treatment and metformin if the A1C is more than 7.5% or
after 3 months of monotherapy without achievement of the patient's blood glucose
goals
what A1c is insulin added?
when in dual therapy indicated?
when is triple line therapy indicated? - ANS-Immediately upon diagnosis of type 2 DM,
begin lifestyle therapy with medically assisted obesity treatment.
• If glycemic goals are still not met 3 months later, begin single-agent or dual therapy
with oral antidiabetic agents, depending on whether A1C is less than or greater than
7.5%.
• If glycemic goals are not met in 3 months, initiate triple therapy.
• If after 3 additional months (or at the time of diagnosis) A1C is 9.0% or higher and the
Scheme
DM1 definition patho - ANS-or absence of functioning beta cells
Autoimmune disorder
Asymptomatic diabetes - ANS-type II diabetes affects nearly 10% of the population, and
due to this high prevalence, potentially severe complications
Prediabetes labs - ANS-1. Prediabetic- fasting glucose consistently elevated above the
normal range but less than 100-125.
Impaired glucose tolerance (IGT) state of hyperglycemia where 2 hr post glucose load
glycemic level is 140-199.
RANDOM glucose test cannot be used to diagnose pre-diabetes. Needs to be fasting or
two-hour glucose tolerance test. A1c greater than 5.7%. Fasting blood glucose greater
than 100 but less than 126. OGTT greater than 140 but less than 200.
Diagnostic Criteria of Diabetes - ANS-However, if the individual is asymptomatic, then a
diagnosis of diabetes mellitus requires two positive tests that are separated by at least
one week of time.
Diagnostic Criteria - ANS-· AIC of 6.5 or higher=diabetes
· Random plasma glucose level of 200 WITH classic symptoms of hyperglycemia or a
hyperglycemic crisis
· Fasting plasma glucose level of 126 or higher on TWOoccasions(fasting is defined as
no caloric intake for at least 8 hrs
· 2 hour glucose tolerance test- 2-hour post load plasma glucose level of 200 or higher
during an OGTT, following consumption of a glucose load containing the equivalent of
75g of anhydrous glucose dissolved in water (OGTT is also used to screen for diabetes
during pregnancy)
screening for type 1 and type 2 - ANS-· You do not screen for type 1 diabetes but you
do screen for type 2 if an individual is overweight or obese, regardless of age, and for all
adults aged 45 years and older. Tests should be repeated at a minimum of 3 year
, intervals
what is the minimum time interval for screening for Diabetes type 2 - ANS-3 years
treatment for Type 1
and what blood sugar level before meals? - ANS-Type 1- FIRST LINE: INSULIN. The
initial goal of treatment for type 1 DM is to normalize the elevated blood glucose level.
This is best accomplished by intensive insulin regimens to achieve the following goals:
plasma glucose levels of 80 to 130 mg/dL before meals
1 - 2 hours postprandial blood sugar
and A1C goal for a type 1 DM? - ANS-(1-2 hours after the beginning of a meal) glucose
levels of less than 180 mg/dL, and an A1C below 7% for adults with type 1 DM.
initiation of insulin therapy - ANS-. INITIATION OF INSULIN THERAPY IN NEWLY
DIAGNOSED TYPE 1 DM, SHOULD BE MANAGED BY OR IN CLOSE
COLLABORATION WITH AN ENDOCRINOLOGIST.
DM 2 Management - ANS-Type 2-FIRST LINE: LIFESTYLE MANAGEMENT
metformin
is first line medication management
when is a second medication added??? - ANS-The AACE recommends adding a
second agent to lifestyle treatment and metformin if the A1C is more than 7.5% or
after 3 months of monotherapy without achievement of the patient's blood glucose
goals
what A1c is insulin added?
when in dual therapy indicated?
when is triple line therapy indicated? - ANS-Immediately upon diagnosis of type 2 DM,
begin lifestyle therapy with medically assisted obesity treatment.
• If glycemic goals are still not met 3 months later, begin single-agent or dual therapy
with oral antidiabetic agents, depending on whether A1C is less than or greater than
7.5%.
• If glycemic goals are not met in 3 months, initiate triple therapy.
• If after 3 additional months (or at the time of diagnosis) A1C is 9.0% or higher and the
