15-01-2014, 03:05 PM
STANDARDS OF MEDICAL CARE IN DIABETES—2013
MEDICAL CARE IN DIABETES.ppt (Size: 2.79 MB / Downloads: 75)
Classification of Diabetes
Type 1 diabetes
β-cell destruction
Type 2 diabetes
Progressive insulin secretory defect
Other specific types of diabetes
Genetic defects in β-cell function, insulin action
Diseases of the exocrine pancreas
Drug- or chemical-induced
Gestational diabetes mellitus (GDM)
Recommendations: Testing for Diabetes in Asymptomatic Patients
Consider testing overweight/obese adults (BMI ≥25 kg/m2) and who have one or more additional risk factors
In those without risk factors, begin testing at age 45 years (B)
If tests are normal
Repeat testing at least at 3-year intervals (E)
Use A1C, FPG, or 2-h 75-g OGTT (B)
In those with prediabetes
Identify and, if appropriate, treat other CVD risk factors (B)
Recommendations:
Detection and Diagnosis of GDM (2)
Screen women with GDM for persistent diabetes at 6–12 weeks postpartum, using OGTT, nonpregnancy diagnostic criteria (E)
Women with a history of GDM should
have lifelong screening for the development of diabetes or prediabetes
at least every 3 years (B)
Women with a history of GDM found to have prediabetes should receive lifestyle interventions or metformin to prevent diabetes (A)
Diabetes Care: Initial Evaluation
A complete medical evaluation should be performed to
Classify the diabetes
Detect presence of diabetes complications
Review previous treatment, risk factor control in patients with established diabetes
Assist in formulating a management plan
Provide a basis for continuing care
Perform laboratory tests necessary to evaluate each patient’s medical condition
Diabetes Care: Glycemic Control
Two primary techniques available for health providers and patients to assess effectiveness of management plan on glycemic control
Patient self-monitoring of blood glucose (SMBG), or interstitial glucose
A1C