Criteria for Diagnosis of Pre-diabetes
Impaired fasting glucose (IFG) ≥ 110 – < 126 mg/dl
(Fasting plasma glucose)
Impaired glucose tolerance (IGT) ≥ 140 – < 200 mg/dl
(2-hr 75g OGTT)
Criteria for Diagnosis of Diabetes
- Random plasma glucose > 200 mg/dl* with symptoms (polyuria, polydypsia, and unexplained w eight loss)
- Fasting plasma glucose > 126 mg/dl*
- 2-hr plasma glucose > 200 mg/dl* after 75g OGTT
*Repeat to confirm on subsequent day
Treatment Goals for the ABCs of Diabetes
Preprandial plasma glucose 90 – 130 mg/dl
Peak postprandial plasma glucose < 180 mg/dl
Hypertension definition >140 and/or >90
Treatment goal <130 and < 80
- Cholesterol – Lipid Profile (mg/dl)
LDL Cholesterol < 100
HDL Cholesterol Men > 40 Women >50
Triglycerides < 150
At each regular diabetes visit:
- Measure w eight and blood pressure.
- Inspect feet.
- Review self-monitoring glucose record.
- Review /adjust medications.
- Recommend regular use of aspirin for CVD prevention.
- Review self-management skills, dietary needs, and physical activity.
- Determine Medicare benefits eligibility for medical nutrition therapy and diabetes self-management education.
- Counsel on smoking cessation and alcohol use.
Twice a year:
- Obtain A1C in patients meeting treatment goals with stable glycemia (quarterly if not).
- Refer for dental exam.
- Obtain fasting lipid profile (less often if normal).
- Obtain serum creatinine and urinalysis for protein and microalbumin.
- Refer for dilated eye exam.
- Perform comprehensive foot exam.
- Administer influenza vaccination.
Usually only once:
- Administer pneumococcal vaccination.