PREDIABETES

Question 1

These are all signs of what diagnosis?

1. impaired fasting glucose (100-125mg/dL)
2. borderline Hgb-A1C elevation (5.7-6.4%)
3. 2 hour post-prandial glucose (140-199mg/dL)

Answer 1

Prediabetes

Question 2

The below is involved in the pathogenesis of what?

1. Insulin resistance (insulin receptors on muscle cells do not adequately respond)
2. Insulin production is decreasing due to autoimmunity (type 1 diabetes) or decreased insulin production (as seen late in the course of type 2 diabetes and referred to as “pancreatic burnout”)

Answer 2

Prediabetes

Question 3

These are all risk factors for what?

1. family history/genetic predisposition
2. obesity
3. diet
4. physical inactivity
5. Race (AA, latino, Native american, asian american, pacific islander)
6. women who delivered a baby weighing 9 pounds or greater or had previous diagnosis of gestational diabetes

Answer 3

Prediabetes

Question 4

True or False

Glucose elevations seen in prediabetes generally will not produce polyuria or polydipsia as seen in Diabetes type 1or 2

Answer 4

True

Question 5

Patients with prediabetes are generally asymptomatic but it is postulated that early sensory nerve toxicity occurs in prediabetes, producing presenting symptoms such as what?

Answer 5

subtle lower extremity paresthesia

Question 6

Can patients who forget to fast cause test results to become obscured enough to show signs of prediabetes?

Answer 6

Yes

Question 7

What is a syndrome that involves excessive cortisol which can be a differential diagnosis of Prediabetes?

Answer 7

Cushings syndrome

Question 8

What are some medications that may explain a differential diagnosis when concerned for prediabetes?

Answer 8

1. corticosteroids
2. antibiotics
3. beta-blockers
4. psychiatric medications
5. thiazide diuretics (HCTZ or Chlorthalidone)

Question 9

Is an increase in physical activity, exercise, and weight loss if overweight or obese an appropriate treatment for prediabetes?

Answer 9

Yes

Question 10

Prediabetes
In obese patients there is an evidence that Metformin 850mg BID may lower the risk of developing type 2 diabetes by what percentage; but is less effective in thin or older patients?

Answer 10

30%