KINE 2475 Lecture Notes - Lecture 51: Weight Loss, Diabetes Mellitus Type 1, Medical Nutrition Therapy

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Screening for diabetes: screen patients for impaired fpg & development of diabetes. Identify patients who are at risk, obtain an fpg & a1c to determine if hyperglycemic. Type 1 diabetes: screen for b-cell autoantibody status in high-risk members. Type 2 diabetes: ada recommends screening for type 2 in asymptomatic obese (bmi>25), asian, should be screened every 3 years, starting 45 years, screening tests are fpg, a1c or 2 hour oral glucose tolerance test (ogtt) Criteria for diagnosis of dm: a1c > 6. 5% (48mmol/mol hb, fasting plasma glucose >125mg/dl (7. 0mmol/l). Fasting for at least 8 hrs: 2-hour plasma glucose >200mg/dl (11. 1 mmol/l) during ogtt. Test is performed using a glucose load containing 75g anhydrous glucose dissolved in water: random plasma concentration >200mg/dl (11. 1 mmol/l) Less stringent goals (a1c <8%) for older patients, limited life expectancy, long duration of diabetes, history of hypoglycemia, serious comorbities, chronic conditions, cognitive impairment, long-term care facilities.

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