Term
| Glycemic Goals for Toddlers & Preschoolers (0-5 yrs) |
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Definition
Before Meals: 100-180 mg/dL;
Bedtime/Overnight: 110-200 mg/dL;
A1c: 7.5-8.5% |
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Term
| Glycemic Goals for School Age Kids (6-12 yrs) |
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Definition
Before Meals: 90-180 mg/dL;
Bedtime/Overnight: 100/180 mg/dL;
A1c: <8% |
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Term
| Glycemic Goals for Adolescents & Young Adults (13-19 yrs) |
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Definition
Before Meals: 90-130 mg/dL;
Bedtime/Overnight: 90-150 mg/dL;
A1c: <7.5% |
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Term
| Screening for Nephropathy in Kids |
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Definition
| Annual microalbumin at 10 yrs AND if child has had DM for 5 yrs |
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Term
| Screening for Retinopathy in Kids |
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Definition
| Annual eye exam once child is 10 yrs AND has had DM for 3-5 years |
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Term
| Screening for HTN in Kids |
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Definition
Goal: BP <130/80 or below 90th percentile for age, sex, and height;
Recommend lifestyle modifications 1st line then pharm tx with ACE-I |
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Term
| Screening for Dyslipidemia in Kids |
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Definition
If strong family hx, FLP performed soon after diagnosis in child >2 yrs old;
If no family hx, FLP at puberty (>=10 yrs old);
Annual monitoring recommended;
Repeat every 5 years if FLP within normal levels |
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Term
| Physiological Changes of Aging |
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Definition
changes in hormones & hormone regulation;
Decreased vision;
Changes in kidney fcn;
Bone loss;
Muscle wasting;
Skin changes; |
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Term
| Psychological Changes of Aging |
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Definition
maintaining independence is a priority;
health care, QOL, functional ability |
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Term
| Developmental Changes of Aging |
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Definition
retirement;
marital changes; widowhood; grandparenting; death & dying; |
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Term
| Treating Type 2 DM in Older Adults |
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Definition
Cardiovascular Risk Reduction: smoking cessation, hyperlipidemia & HTN control;
Glycemic control --> improvements in dementia, memory, energy levels, physical activity, mood, QOL;
Glycemic Targets may be more conservative & geared toward improvement in QOL |
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Term
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Definition
carbohydrate intolerance with onset or first recognition during pregnancy;
most common complicatoin: newborn macrosomia (>9 lbs) |
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Term
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Definition
| Obesity (BMI >30), age >25, hx of abnormal glucose metabolism, high risk ethnic group (NA, HA, AA), PCOS, strong family hx of DM |
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Term
| Screening for High-risk pregnant pts |
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Definition
presence of any risk factors;
1st prenatal visit and again at 24-28 wks |
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Term
| Screening for Average-Risk Pregnant Pts |
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Definition
don't fall into high- or low-risk;
Screen at 24-28 wks; |
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Term
| Screening for Low-risk pregnant pts |
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Definition
Meet ALL of following: <25 yrs, normal body weight, no family hx of DM, no hx of abnormal glucose, not a member of high-risk ethnic group;
Optional screening |
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Term
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Definition
during 2nd or 3rd trimester;
Must meet EITHER of criteria:
1) general diagnostic criteria of DM
2) OGTT 50 g or 100 g load - 2 or more of plasma glucose values must be met or exceeded for (+) diagnosis
FPG: >=95 mg/dL
1 hr: >=180 mg/dL
2 hr: >=155 mg/dL
3 hr: >=140 mg/dL |
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Term
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Definition
fetal macrosomia (>4000g, 8.8 lbs);
traumatic birth injuries;
postpartum hypoglycemia;
hypocalcemia;
hypomagnesemia;
polycythemia;
cardiomyopathy;
hyperbilirubinemia;
respiratory distress syndrome;
still birth;
long-term: Type 2 DM, increased obestiy in offspring |
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Term
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Definition
| daily SMBG: TID-QID at minimal; |
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Term
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Definition
Preprandial: <= 95 mg/dL;
1 hr PP <= 140 mg/dL;
2 hr PP <= 120 mg/dL |
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Term
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Definition
No oral therapies approved;
may use glyburide or metformin, but not recommended;
Insulin --> use rapid-acting (lispro/aspart - Preg. B) or regular human insulins |
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Term
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Definition
Medical Nutrition Therapy (MNT) is CORNERSTONE of tx, needs to fulfill minimum requirements for pregnancy;
balance food intake w/ insulin administration to maintain euglycemia; |
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Term
| General Guidelines for ALL pregnant women |
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Definition
vit.-mineral supplement w/ 400-800 mcg of folic acid daily;
avoid EtOH & smoking;
limit caffeine to <300 mg/day;
limit artificial sweeteners;
consume fish high in omega-3s but avoid fish high in mercury (shark, mackerel, swordfish);
weight management |
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Term
| Protein Recommendations for Pregnant Women |
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Definition
0.8 g/kg/day during 1st half of pregnancy;
1.1 g/kg/day during 2nd half of pregnancy;
add 50g/day for twins |
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Term
| Carb Recommendation for Pregnancy |
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Definition
Same as preconceptoin intake;
minimum of 175 g/day assure fuel for both mother & fetus |
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Term
| Calories Recommendation for Pregnancy |
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Definition
no change in 1st trimester;
300 kcal/day additionally in subsequent trimesters |
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Term
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Definition
normal glucose tolerance returns after delivery;
hx of GDM are regularly screened for Type 2 DM;
Preconception planning emphasized for future pregnancies |
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