CDCES flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Type 1 diabetes mechanism

Autoimmune destruction of pancreatic beta cells causes absolute insulin deficiency, usually with positive islet autoantibodies such as GAD65, IA-2, ZnT8, or insulin; lifelong exogenous insulin is required.

Type 2 diabetes pathophysiology

Insulin resistance combined with progressive beta-cell failure produces relative insulin deficiency; type 2 diabetes accounts for about 90%–95% of diagnosed diabetes in U.S. adults and is strongly associated with obesity.

Diabetes diagnostic A1C threshold

An A1C of 6.5% or higher meets a diabetes diagnostic criterion; confirmation with a second abnormal test is generally required unless hyperglycemia is unequivocal.

Prediabetes A1C range

Prediabetes is defined by A1C 5.7%–6.4%, fasting plasma glucose 100–125 mg/dL, or 2-hour OGTT glucose 140–199 mg/dL.

DPP lifestyle reduction

In the Diabetes Prevention Program, intensive lifestyle intervention reduced progression from impaired glucose tolerance to type 2 diabetes by 58%, compared with 31% for metformin.

Gestational diabetes definition

Gestational diabetes is glucose intolerance first recognized during pregnancy; it increases future maternal type 2 diabetes risk and is usually screened for at 24–28 weeks.

MODY inheritance pattern

Maturity-onset diabetes of the young is monogenic and autosomal dominant, often diagnosed before age 25; common forms involve GCK or HNF1A and are not autoimmune.

A1C target most adults

The A1C goal is below 7% for most nonpregnant adults; less stringent goals such as below 8% are used for limited life expectancy, severe hypoglycemia risk, or advanced complications.

Preprandial glucose target

Preprandial capillary glucose target is 80–130 mg/dL, and peak postprandial glucose target is below 180 mg/dL measured 1–2 hours after the start of a meal.

Metformin eGFR contraindication

Metformin is contraindicated when estimated glomerular filtration rate is below 30 mL/min/1.73 m²; it is first-line therapy for type 2 diabetes unless contraindicated.

SGLT2 inhibitor key risks

SGLT2 inhibitors cause glycosuria and can cause genital mycotic infections, volume depletion, and euglycemic diabetic ketoacidosis; they reduce heart failure hospitalization and CKD progression.

GLP-1 RA contraindication

GLP-1 receptor agonists are contraindicated with a personal or family history of medullary thyroid carcinoma or MEN2; common effects include nausea, vomiting, and weight loss.

Rapid-acting insulin timing

Rapid-acting insulin analogs such as lispro, aspart, and glulisine begin in 5–15 minutes, peak near 1 hour, and last 3–5 hours.

Hypoglycemia high-risk drugs

Insulin and sulfonylureas carry the highest hypoglycemia risk; metformin, DPP-4 inhibitors, SGLT2 inhibitors, and GLP-1 receptor agonists have low intrinsic hypoglycemia risk.

Carbohydrate choice grams

One carbohydrate choice equals 15 grams of carbohydrate; mealtime insulin dosing can use an individualized insulin-to-carbohydrate ratio.

Fiber recommendation diabetes

Adults with diabetes are advised to consume at least 14 grams of fiber per 1,000 kcal, commonly about 25–30 grams per day.

Weight loss glycemic threshold

Weight loss of 5%–7% of body weight improves glycemia and reduces progression to type 2 diabetes; loss of 10% or more can produce greater metabolic benefit.

Exercise weekly recommendation

Recommended physical activity is at least 150 minutes per week of moderate-intensity aerobic activity plus 2–3 sessions per week of resistance training.

Post-exercise hypoglycemia risk

Aerobic activity can lower blood glucose during and for up to 24 hours after exercise, increasing hypoglycemia risk in people using insulin or sulfonylureas.

Sedentary interruption frequency

Prolonged sedentary time should be interrupted every 30 minutes with light activity such as standing or walking.

DSMES critical times

DSMES is recommended at diagnosis, annually or when targets are not met, when complicating factors develop, and during transitions in care.

ADCES7 self-care behaviors

The ADCES7 behaviors are healthy coping, healthy eating, being active, taking medication, monitoring, reducing risks, and problem solving.

Diabetes distress prevalence

Diabetes distress affects roughly 20%–40% of adults with diabetes and is distinct from major depression, although the two conditions commonly co-occur.

Motivational interviewing OARS

Motivational interviewing is collaborative and autonomy-supportive; core skills include open questions, affirmations, reflections, and summaries, known as OARS.

Transtheoretical model stages

The stages are precontemplation, contemplation, preparation, action, maintenance, and possible relapse; progression is not necessarily linear.

Teach-back method

Teach-back confirms understanding by asking patients to explain information in their own words; it is a health-literacy strategy that reveals gaps.

CGM time in range targets

CGM targets are time in range 70–180 mg/dL above 70%, time below 70 mg/dL under 4%, time below 54 mg/dL under 1%, and time above 250 mg/dL under 5%.

Glucose management indicator formula

Glucose management indicator in percent equals 3.31 plus 0.02392 multiplied by mean glucose in mg/dL; it estimates A1C from CGM data.

Albuminuria definition

Albuminuria is a urine albumin-to-creatinine ratio of 30 mg/g or higher; adults with diabetes should be screened annually with UACR and eGFR.

Retinopathy screening start

Retinopathy screening begins within 5 years of type 1 diagnosis and at type 2 diagnosis, then annually or every 1–2 years if no retinopathy is present.

Hypoglycemia 15-15 rule

Treat hypoglycemia with 15 grams of fast-acting carbohydrate, recheck glucose in 15 minutes, and repeat until glucose is above 70 mg/dL; use glucagon for severe cases.

DKA diagnostic criteria

DKA criteria include glucose above 250 mg/dL, arterial pH below 7.3, bicarbonate below 18 mEq/L, anion gap, and ketonemia or ketonuria; HHS has minimal ketones.