Diabetes At A Glance

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

  • HbA1C < 7 %

Preprandial plasma glucose 90 – 130 mg/dl

Peak postprandial plasma glucose < 180 mg/dl

  • Blood pressure (mmHg)

Systolic           Diastolic

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.

Annually:

  • 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.