Diabetes For Rehab Final NC - Indiana Society of ：糖尿病康复最终数控印第安娜社会

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1、UpdateonDiabetesMedicationsandGuidelinesinCardiopulmonaryRehabSettingRajaHanania,R.Ph,CDM,CDE,BCPSClinicalPharmacySpecialistCriticalCare/DiabetesCareIU-Health-BloomingtonHospitalBloomington-IndianaObjectivesLearnabouttheimpactofdiabetesintheUnitedStatesRevieworalandinjectablediabetesm

2、edicationsandtheirroleindiabetesmanagementReviewthe2013ADAgeneralrecommendationswithspecialemphasisonphysicalactivityandexerciseinthecardiopulmonaryrehabsettingNationalDiabetesEstimates25.8millionAmericans(8.3%oftheUSpopulation)7millionundiagnosed79millionAmericanadultsaged20yearsorol

3、derqualifyasbeingathighrisktodevelopdiabetes(fastingglucosebetween100and125)Ifthetrendcontinues,1-in-3Americanadultswillhavediabetesby2050The7thleadingcauseofdeathintheUSTheleadingcauseofblindness,renalfailureandnontraumaticamputationsbetweentheageof20-74Cost:U.S.nationaleconomicburde

4、nofpre-diabetesanddiabetesreached$245billionin2012,$218 billionin2007,$132billionin2002vs.$44billionin1997CDCNationalDiabetesFactSheet2011.ADAdiabetesStatistics2013MakingtheDiagnosisFastingPlasmaGlucoseTest99orbelow=Normal100to125=Pre-diabetes(impairedfastingglucose(IFG))≥126=Diabetes

5、OralGlucoseToleranceTest(OGTT)2hrplasmaglucoseresult:139andbelow=Normal140-199=Pre-diabetes(impairedglucosetolerance(IGT))200andabove=DiabetesRandomPlasmaGlucoseTest200ormorepluspresenceofsymptoms(polydypsia/polyuria/polyphagia)=DiabetesResultsshouldbeconfirmedbyrepeatingthetestonanot

6、herdaypriortodiagnosisA1c≥6.5%(new2010criteriafordiagnosis)ClassificationofDiabetesInsulin-DependentDiabetesMellitus(TypeI)Highanti-betacellantibodiesLowplasmainsulinconcentration(determinedbyC-peptidelevels)UsuallyleanandyoungpatientsbutthistrendinchangingNon-Insulin-DependentDiabete

7、sMellitus(TypeII)SeruminsulinlevelsnormalorelevatedbutstillhaverelativeinsulindeficiencyMetabolismdoesnotrespondproperlytoinsulin=insulinresistanceUsuallyobese(60-90%)andolderbutthinstrendischangingLosingweightfrequentlybringsglucoselevelsandinsulinsensitivitybackundercontrolStronggen

8、eticl