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Medicine

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Endocrine

Question
23 out of 28
 

Goal of treatment is a diabetic patient is:



A 6%
B 6.5%
C 7%
D 7.5%

Ans. C

7%

Extra Edge: (Ref. Hari-18th ed. Pg- 2990, table 344.8)

Goals of treatment in a diabetic patient: To achieve


1). Pre-prandial blood sugar 70 – 130 mg%PP blood sugar < 180 mg%

2). HbA1C < 7

3). BP < 130 / <80 mmHg. If the patient has associated renal disease than target is (<125 / <75 mmHg is)

4). LDL <100 mg%

5). Tg <150 mg%

6). HDL >40mg% in male, >50mg% in female


Extra Edge: Recent Advances

Newer emerging trend (Ref. Hari-18th ed. Pg- 3000)

1). Whole pancreas transplantation (performed concomitantly with a renal transplant) may normalize glucose tolerance

2). Pancreatic islet transplantation has been plagued by limitations in pancreatic islet supply and graft survival.

After Successful pancreatic transplantation

a. Complication that may be reversed / healed

i. Early diabetic nephropathy (microalbuminuria stage)

ii. Diabetic neuropathy

b. Complications that do not appear to be reversed / healed.

i. Diabetic retinopathy ii. Peripheral vascular disease

3. Closed-loop pumps that infuse the appropriate amount of insulin in response to changing glucose levels

4. Bariatric surgery for markedly obese individuals with type 2 diabetes. The ADA clinical guidelines state that bariatric surgery should be considered in individuals with DM and a BMI >35 kg/m2.

5. New therapies under development for type 2 diabetes include

a. activators of glucokinase,

b. an inhibitor of 11 -hydroxysteroid dehydrogenase-1,

c. Salsalate.

Endocrine Flashcard List

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