Diabetes Mellitus and Metabolic Syndrome
questions and answers
metabolic syndrome - ✅✅a constellation of findings that predisposes to DM, CAD, strokes; requires
presence of any *3* of the following 5 traits:
1) waist circumference ≥ 102 cm (40 in) in men or ≥88 cm (35 in) in women
2) TG ≥150 mg/dL
3) serum HDL <40 mg/dL in men and <50 mg/dL in women
4) BP ≥130/85 mmHg
5) *fasting plasma glucose ≥100 mg/dL*
*some criteria specify a DM dx*
metabolic syndrome pathophysiology - ✅✅1) ↑ thrombogenicity of blood
2) ↑ circulation of inflammatory cytokines
3) endothelial dysfunction
4) ↑ arterial stiffness
5) ↑ oxidative stress
true - ✅✅true or false: the individual components of metabolic syndrome are predictive of future
adverse clinical outcomes
metabolic syndrome epidemiology - ✅✅1) >25% of Americans meet dx criteria
2) prevalence ↑ w/ age: ~40% of population >60yo
3) similar prevalence in males and females
4) specific concerns for women:
PCOS, pregnancy, and use of oral contraceptives
5) social determinates of health:
higher rates in those w/ lower socioeconomic status
,true - ✅✅true or false: there is no consensus on the definition of metabolic syndrome in children and
adolescents
metabolic syndrome risk factors - ✅✅1) FH
2) unhealthy diet
3) sedentary lifestyle
4) smoking
5) EtOH
6) central obesity: visceral fat is pro-inflammatory
7) insulin resistance
8) sleep disturbances, OSAS
metabolic syndrome - ✅✅the following obesity-related disorders are all associated w/ this condition:
1) fatty liver disease
2) CKD
3) PCOS
4) OSAS
5) hyperuricemia and gout
metabolic syndrome complications - ✅✅1) T2DM
2) CVD
pt requires aggressive lifestyle modification focused on weight reduction and increased physical activity:
1) monitor BP
2) measure waist circumference
3) check fasting lipid profile
4) monitor fasting glucose
false - ✅✅true or false: metabolic syndrome is not associated w/ increased risk for cognitive decline
and dementia in older adults
, metabolic syndrome tx - ✅✅1) aggressive lifestyle modifications
2) manage dyslipidemia & HTN per ACC guidelines
3) add ASA for primary prevention if >10% 10yr CVD risk and >50yrs (USPSTF)
4) screen for OSAS and tx w/ CPAP if indicated, sleep hygiene
5) refer to a registered dietician
6) consider initiating metformin if suspect progression to T2DM
7) bariatric surgery may be appropriate for some pt
DM epidemiology - ✅✅1) over 30 million Americans dx
2) more than doubles the annual healthcare cost for a single pt
3) responsible for 15% of US healthcare spending and 30% of the total Medicare budget
4) 7th leading cause of death in the US
DM - ✅✅leading cause of:
1) end-Stage Renal Disease
2) blindness
3) non-traumatic lower limb amputation
pancreatic hormones - ✅✅1) gastrin
2) vasoactive intestinal peptide (VIP)
3) glucagon
4) insulin
5) somatostatin
gastrin - ✅✅pancreatic hormone that aids digestion by stimulating acid secretion
vasoactive intestinal peptide - ✅✅VIP
questions and answers
metabolic syndrome - ✅✅a constellation of findings that predisposes to DM, CAD, strokes; requires
presence of any *3* of the following 5 traits:
1) waist circumference ≥ 102 cm (40 in) in men or ≥88 cm (35 in) in women
2) TG ≥150 mg/dL
3) serum HDL <40 mg/dL in men and <50 mg/dL in women
4) BP ≥130/85 mmHg
5) *fasting plasma glucose ≥100 mg/dL*
*some criteria specify a DM dx*
metabolic syndrome pathophysiology - ✅✅1) ↑ thrombogenicity of blood
2) ↑ circulation of inflammatory cytokines
3) endothelial dysfunction
4) ↑ arterial stiffness
5) ↑ oxidative stress
true - ✅✅true or false: the individual components of metabolic syndrome are predictive of future
adverse clinical outcomes
metabolic syndrome epidemiology - ✅✅1) >25% of Americans meet dx criteria
2) prevalence ↑ w/ age: ~40% of population >60yo
3) similar prevalence in males and females
4) specific concerns for women:
PCOS, pregnancy, and use of oral contraceptives
5) social determinates of health:
higher rates in those w/ lower socioeconomic status
,true - ✅✅true or false: there is no consensus on the definition of metabolic syndrome in children and
adolescents
metabolic syndrome risk factors - ✅✅1) FH
2) unhealthy diet
3) sedentary lifestyle
4) smoking
5) EtOH
6) central obesity: visceral fat is pro-inflammatory
7) insulin resistance
8) sleep disturbances, OSAS
metabolic syndrome - ✅✅the following obesity-related disorders are all associated w/ this condition:
1) fatty liver disease
2) CKD
3) PCOS
4) OSAS
5) hyperuricemia and gout
metabolic syndrome complications - ✅✅1) T2DM
2) CVD
pt requires aggressive lifestyle modification focused on weight reduction and increased physical activity:
1) monitor BP
2) measure waist circumference
3) check fasting lipid profile
4) monitor fasting glucose
false - ✅✅true or false: metabolic syndrome is not associated w/ increased risk for cognitive decline
and dementia in older adults
, metabolic syndrome tx - ✅✅1) aggressive lifestyle modifications
2) manage dyslipidemia & HTN per ACC guidelines
3) add ASA for primary prevention if >10% 10yr CVD risk and >50yrs (USPSTF)
4) screen for OSAS and tx w/ CPAP if indicated, sleep hygiene
5) refer to a registered dietician
6) consider initiating metformin if suspect progression to T2DM
7) bariatric surgery may be appropriate for some pt
DM epidemiology - ✅✅1) over 30 million Americans dx
2) more than doubles the annual healthcare cost for a single pt
3) responsible for 15% of US healthcare spending and 30% of the total Medicare budget
4) 7th leading cause of death in the US
DM - ✅✅leading cause of:
1) end-Stage Renal Disease
2) blindness
3) non-traumatic lower limb amputation
pancreatic hormones - ✅✅1) gastrin
2) vasoactive intestinal peptide (VIP)
3) glucagon
4) insulin
5) somatostatin
gastrin - ✅✅pancreatic hormone that aids digestion by stimulating acid secretion
vasoactive intestinal peptide - ✅✅VIP
