Diabetes: Clinical Presentation, Screening, and Diagnostics
The “classic triad” of symptoms in new-onset Type 1 diabetes.
What are polyuria, polydipsia, and polyphagia?
For most adults with diabetes, the A1C target is less than this value.
What is 7%?
Lipid change from exercise you should highlight to a patient with T2DM asking “why bother?”
What are ↓ triglycerides and ↑ HDL
Newly diagnosed T2DM, A1C 8.5%—the drug to start with lifestyle modification.
What is metformin (a biguanide)?
Worldwide, this deficiency is the leading cause of hypothyroidism.
What is iodine deficiency?
A patient with a BMI of 22 falls into this weight category.
What is healthy weight?
A random plasma glucose ≥200 mg/dL with classic symptoms meets criteria for this diagnosis.
What is diabetes mellitus?
A falsely high A1C may occur in patients with these types of anemia.
What are iron, B12, or folate deficiency anemias?
If A1C is not at goal after 3 months in type 2 diabetes, this should be added.
What is an oral agent (e.g., metformin)?
These injectable agents increase insulin release with meals, decrease glucagon, slow gastric emptying, and promote weight loss.
What are GLP-1 receptor agonists (e.g., semaglutide, liraglutide)?
A patient with ↑ TSH and ↓ Free T4 likely has this type of thyroid disease.
What is primary hypothyroidism?
At 5’0” and 150 lb (BMI 29.3), the correct weight category is this.
What is overweight?
Annual specialty screening every person with type 1 diabetes should receive.
What is a yearly dilated eye exam?
This blood product can cause either falsely high or falsely low A1C, depending on storage medium and dilutional effects.
What is an RBC transfusion?
Add insulin in Type 2 diabetes when this A1C threshold or persistent hyperglycemia is reached despite oral meds.
What is A1C > 10% (or persistent hyperglycemia despite oral agents)?
Metformin must be avoided or discontinued if the patient’s GFR falls below this value.
What is < 30 mL/min (avoid/contraindicated; use caution if < 40 mL/min)?
High TSH with normal Free T4 describes this thyroid state.
What is subclinical hypothyroidism?
This syndrome is defined by a cluster of ↑BP, ↑BG, central obesity, and abnormal cholesterol.
What is metabolic syndrome (Syndrome X)?
The ADA recommends screening for type 2 diabetes in adults with this anthropometric risk.
What is being overweight?
The preferred monitoring method for type 1 diabetes.
What is Continuous Glucose Monitoring (CGM)?
A low reading triggers the “15 in 15” rule; give one immediate glucose source example your patient could take now.
What is a fast-acting 15-gram carbohydrate (e.g., 4 oz juice) per the 15-in-15 instruction)?
Sulfonylureas commonly cause this side effect that patients need to recognize and treat promptly.
What is hypoglycemia?
This medication is preferred for initial treatment of hyperthyroidism unless the patient is pregnant in the first trimester.
What is methimazole?
These medications work by increasing insulin, lowering glucagon, and slowing gastric emptying to promote satiety.
What are GLP-1 receptor agonists (semaglutide, liraglutide)?
Two screenings every person with diabetes should get?
What are (e.g.) a dilated eye exam and a foot exam?
If CGM is not available, how many times per day should type 1 patients check glucose?
What is 3–4 times per day?
Screening test to include in a patient with recurrent vaginal candidiasis.
What is hemoglobin A1C?
A lab clue that your patient is actually taking their SGLT2 inhibitor.
What is glycosuria?
Radioactive iodine therapy is specifically considered for this etiology of hyperthyroidism.
What is Graves disease?
For nocturnal reflux symptoms in overweight patients, counsel to avoid this activity.
What is weightlifting?