NURS 5433 DIABETES NEW EXAM WITH 100%
VERIFIED SOLUTIONS
How to dx metabolic syndrome?
•When 3 or more of the following 5 criteria are present—then patient has Metabolic
Syndrome [CDC, 2021]
-Waist circumference—men >40 inches; women >35 inches
-Triglycerides >150 mg/dL
-HDL cholesterol—men <40 mg/dL; women <50 mg/dL
-Blood Pressure >130/85
-FBS >100 mg/dL
What else can we call metabolic syndrome?
•Also known as:
-Insulin Resistance Syndrome
-Cardiovascular Dysmetabolic Syndrome
-ICD-10 Code is E88.81
and should be listed as a DX
Acanthosis Nigricans
-Hyperkeratotic condition, diffuse hyperpigmented velvety thickening of the cutaneous
skin of neck and axillae
-1st visible sign is darkening of the skin, so that it appears dirty
-Eventually, this skin becomes rugose and mamillated
,ndiagnositcs for metabolic syndrome:
•It is a clinical diagnosis—assess:
•BMI
•Waist circumference
•Fasting HDL & trigs
•Microalbumin
•Uric acid level
•Some diagnostics can be used [ordinarily not needed]
-Fasting plasma insulin level
-If level >10 mcg/ml indicates IR
-Elevated insulin levels with a normal glucose level is the hallmark of insulin resistance
-Not usually measured in primary care
differential diagnosis of metabolic syndrome:
•Type II Diabetes
•Prediabetes
•Polycystic Ovarian Syndrome
•Genetic Syndromes
-Down's Syndrome
-Turner's Syndrome
-Muscular Dystrophies
management of metabolic syndrome:
•Pharmacologic interventions
-Antihypertensives
, -Statins
-ASA per guideline and those with CHD/CV disease
-Possibly Metformin
-Can reduce possibility of diabetes by 38%
-But, good lifestyle changes can reduce possibility of diabetes by 58!!!!
ACEI and ARBs do not worsen insulin resistance or lipid profiles and offer renal
protection [Considered DOC for these patients]
** do not use beta blcokers--worsen IR and decrease glucose uptake by 25-37%
cholesterol goals
Trig. <150
LDL <100
HDL >40 mg/dl men, >50mg/dl women (wt loss, stop smoking, vigorous excersice increa.
HDL)
ASA THERAPY FOR MEN >55 FOR MI
RISK IN WOMEN >65 FOR CVA
IR is the pathophy. hallmark of IGT and type 2 DM
Review prevalence trends for diabetes in the U.S. with emphasis on different racial and
ethnic groups.
o High risk groups: Native American, Black, Hispanic = highest risk
o High risk in obese population
Identify at least 5 risk factors for diabetes.
o Sedentary lifestyle
VERIFIED SOLUTIONS
How to dx metabolic syndrome?
•When 3 or more of the following 5 criteria are present—then patient has Metabolic
Syndrome [CDC, 2021]
-Waist circumference—men >40 inches; women >35 inches
-Triglycerides >150 mg/dL
-HDL cholesterol—men <40 mg/dL; women <50 mg/dL
-Blood Pressure >130/85
-FBS >100 mg/dL
What else can we call metabolic syndrome?
•Also known as:
-Insulin Resistance Syndrome
-Cardiovascular Dysmetabolic Syndrome
-ICD-10 Code is E88.81
and should be listed as a DX
Acanthosis Nigricans
-Hyperkeratotic condition, diffuse hyperpigmented velvety thickening of the cutaneous
skin of neck and axillae
-1st visible sign is darkening of the skin, so that it appears dirty
-Eventually, this skin becomes rugose and mamillated
,ndiagnositcs for metabolic syndrome:
•It is a clinical diagnosis—assess:
•BMI
•Waist circumference
•Fasting HDL & trigs
•Microalbumin
•Uric acid level
•Some diagnostics can be used [ordinarily not needed]
-Fasting plasma insulin level
-If level >10 mcg/ml indicates IR
-Elevated insulin levels with a normal glucose level is the hallmark of insulin resistance
-Not usually measured in primary care
differential diagnosis of metabolic syndrome:
•Type II Diabetes
•Prediabetes
•Polycystic Ovarian Syndrome
•Genetic Syndromes
-Down's Syndrome
-Turner's Syndrome
-Muscular Dystrophies
management of metabolic syndrome:
•Pharmacologic interventions
-Antihypertensives
, -Statins
-ASA per guideline and those with CHD/CV disease
-Possibly Metformin
-Can reduce possibility of diabetes by 38%
-But, good lifestyle changes can reduce possibility of diabetes by 58!!!!
ACEI and ARBs do not worsen insulin resistance or lipid profiles and offer renal
protection [Considered DOC for these patients]
** do not use beta blcokers--worsen IR and decrease glucose uptake by 25-37%
cholesterol goals
Trig. <150
LDL <100
HDL >40 mg/dl men, >50mg/dl women (wt loss, stop smoking, vigorous excersice increa.
HDL)
ASA THERAPY FOR MEN >55 FOR MI
RISK IN WOMEN >65 FOR CVA
IR is the pathophy. hallmark of IGT and type 2 DM
Review prevalence trends for diabetes in the U.S. with emphasis on different racial and
ethnic groups.
o High risk groups: Native American, Black, Hispanic = highest risk
o High risk in obese population
Identify at least 5 risk factors for diabetes.
o Sedentary lifestyle
