Type the title in bold ( signika ) all in one line
Study guide:
Definitions:
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Clinical syndrome characterized by chronic hyperglycemia and metabolic abnormalities.
Epidemiology:
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34.1% in adult males and 27.6% in adult females in the Saudi community.
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Estimated ~150 million people have DM worldwide.
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Amongst the Leading causes of adult onset blindness, kidney failure, and non-traumatic lower limb amputations.
Types:
Screening:
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DM1: Subclinical prodrome can be detected in 1st and 2nd-degree relatives of those with DM1 by the presence of pancreatic islet autoantibodies.
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DM2: (in asymptomatic adults):
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Overweight or obese (BMI ≥25 or ≥23 in Asian Americans) who have ≥1 diabetes risk factor.
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Begin at age 45, especially if overweight or obese.
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If normal results: repeat testing in ≥3-yr intervals.
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Managment:
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Non-pharmacological:
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Lifestyle modifications:
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Weight loss (DM type II).
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Physical activity (according to ADA 2015 guidelines): check the table below.
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Smoking cessation including e-cigarettes.
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Bariatric surgery in type II DM (for BMI≥35).
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Pharmacological:
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Oral hypoglycemic agents.
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Insulin.
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Diabetes risk factors:
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Physical inactivity
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First-degree relative with diabetes
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High-risk race/ethnicity
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Women who delivered a baby > 9 lbs. or were diagnosed with GDM
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HDL-C <35 mg/dL ± TG >250 mg/dL
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Hypertension (≥140/90 mm Hg or on therapy)
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A1C ≥5.7%, IGT, or IFG on previous testing
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Conditions associated with insulin resistance: severe obesity, Acanthosis Nigricans, and PCOS.
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CVD history
Chronic Complications:
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Microvascular:
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Retinopathy:
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Nonprolirative (most common).
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The leading cause of blindness in the USA.
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Nephropathy:
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Protein loss.
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Nodular glomerular sclerosis (Kimmelsteil-Wilson syndrome).
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Screening is done by checking for Microalbuminurea
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The leading cause of renal failure.
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Neuropathy:
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Peripheral neuropathy:
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Sensory and motor weakness.
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The main cause of skin ulcers in the feet is decreased sensation due to peripheral
neuropathy. -
The leading cause of non-traumatic limb amputations in USA.
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Autonomic neuropathy:
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Erectile dysfunction in men (most common presentation).
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Postural hypotension.
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Neurogenic bladder.
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Gastroparesis.
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Constipation and diarrhea.
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Figure1: Please write description as text
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Macrovascular:
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Atherosclerosis:
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Increased risk of MI (silent) and CHF.
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DM is a CAD risk equivalent.
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Main cause of death.
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Cerebrovascular disease.
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Peripheral vascular disease.
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Acute Complications:
References:
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Kumar, Parveen J, and Michael L Clark. Kumar & Clark's Clinical Medicine. Print.
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Howland, Richard D et al. Pharmacology. Philadelphia: Lippincott Williams & Wilkins, 2006. Print.
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Hldemo.ebscohost.com,. '| Diabetes Mellitus Type 2 In Adults'. N.p., 2015. Web. 5 Nov. 2015.
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Haas, L. et al. 'National Standards For Diabetes Self-Management Education And Support'. Diabetes Care 37.Supplement_1 (2013): S144-S153. Web. 5 Nov. 2015.
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Hall, Justin, and Azra Premji. Toronto Notes For Medical Students, Inc. © 2015. 2015. Print.
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Agabegi, Steven S, Elizabeth D Agabegi, and Adam C Ring. Step-Up To Medicine. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins, 2013. Print.
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Fischer, Conrad. Master The Boards. Print.
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Perez, Mayra, Lindsay K Botsford, and Winston Liaw. Déjà Review. New York: McGraw-Hill Medical, 2011. Print.
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(DM), Diabetes. 'Diabetes Mellitus (DM) - Endocrine And Metabolic Disorders'. Merck Manuals Professional Edition. N.p., 2015. Web. 5 Nov. 2015.
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Emedicine.medscape.com,. 'Type 1 Diabetes Mellitus: Practice Essentials, Background, Pathophysiology'. N.p., 2015. Web. 5 Nov. 2015.
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Al-Rubeaan, Khalid et al. 'Epidemiology Of Abnormal Glucose Metabolism In A Country Facing Its Epidemic: SAUDI-DM Study'. Journal of Diabetes 7.5 (2014): 622-632. Web.
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Aljabri, KhalidS, SamiaA Bokhari, and KhalidA Alqurashi. 'Prevalence Of Diabetes Mellitus In A Saudi Community'. Annals of Saudi Medicine 31.1 (2011): 19. Web.
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ProProfs,. 'DIABETIC FOOT'. N.p., 2015. Web. 5 Nov. 2015. (Figure1).
First author: Lama Al Luhidan
Second author: Roaa Amer
Reviewed by: Abdullah AlAsaad
Haifa Al Issa
Husam Al Tahan
Format Editor: Adel Yasky
Bayan Alzomaili
Audio recording:
Read by: Thekra AlGholaiqa
Directed by: Rana Alzahrani
Audio production: Bayan Alzomaili