Non fasting screening bloods in CVD risk assessment: role of HbA1c and non fasting

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Non fasting screening bloods in CVD risk assessment: role of HbA1c and non fasting"

Transcription

1 Non fasting screening bloods in CVD risk assessment: role of HbA1c and non fasting cholesterol Mrs Susan Prosser Consultant Clinical Scientist Biochemistry Department Withybush General Hospital

2 Diagnosis of DM WHO Recommendation 2011 HbA1c can be used as a diagnostic test for diabetes providing that stringent quality assurance tests are in place and assays are standardised to criteria aligned to the international reference values, and there are no conditions present which preclude its accurate measurement. An HbA1c of 48 mmol/mol is recommended as the cut point for diagnosing gdiabetes. A value of less than 48 mmol/mol does not exclude diabetes diagnosed using glucose tests.

3 What is HbA1c? f h l i bl d bi d Some of theglucose in blood binds to haemoglobin. This combination of glucose and haemoglobin is called haemoglobin A1c (HbA1c). The amount of HbA1c formed is directly related to the average concentration of glucose in the bloodstream. Red blood cells live for 2 3 months, and because of this, the amount of HbA1c in blood reflects the average level of glucose in the patient s blood during the last 2 3 months.

4 HbA1c continued If the patient has an abnormal type of haemoglobin, for example sickle cell disease, accurate results will depend on the method used to measure HbA1c. If the patient has haemolysis or heavy bleeding, test results may be falsely low. Finally, if the patient is iron deficient, this may raise the HbA1c result.

5 HbA1c analysis Tosoh G7/8 HbA1c results are directly measured and not clinically affected by the presence of most haemoglobin variants.

6 Patient example 41 year old male 24/07/ /10/2015 HbA1c 58 Hb ( )

7 Patient example 41 year old male 24/07/ /10/ /03/2016 HbA1c Hb ( )

8 NG17 Type 1 Diabetes in adults: diagnosis and management If HbA1c monitoring is invalid because of disturbed erythrocyte y turnover or abnormal haemoglobin type, estimate trends in blood glucose control using one of the following: fructosamine estimation quality controlled blood glucose profiles total glycated haemoglobin estimation (if abnormal haemoglobins). [2015]

9 NG28 Type 2 Diabetes in adults: management If HbA1c monitoring is invalid because of disturbed erythrocyte y turnover or abnormal haemoglobin type, estimate trends in blood glucose control using one of the following: quality controlled plasma glucose profiles total glycated haemoglobin estimation (if abnormal haemoglobins) fructosamine estimation. [2015]

10 Fructosamine Fructosamine is the name given to ketoamine products formed from the non enzymatic attachment of a carbohydrate to a protein It cannot be used to diagnose diabetes It reflects average glucose over last 1 3 weeks Measurements may be invalid when there are significant abnormalities of plasma protein concentrations ti eg in nephrotic syndrome, liver cirrhosis, paraproteinaemias,during an acute phase response and in untreated thyroid disease

11 Fructosamine Fructosamine in a healthy population: umol/l Results greater than this range indicate hyperglycaemia during thepreceding 1 3 weeks or longer There are limited and conflicting data in the literature on both thecorrelation with HbA1c and with clinical outcomes in diabetes

12 HbA1c summary No fasting required Result affected by anaemia of any cause and may be either increased or decreased depending on the cause of the anaemia HbA1c should not be replaced by fructosamine without good reason HbA1c must not be used as the sole test to diagnose diabetes in symptomatic ti children or patients with symptoms suggesting type 1 DM

13

14 Lipid profile reported tdacross Wl Wales Pre June 2015 consisted of Total cholesterol (TC) Triglycerides (TG) HDL cholesterol (HDL) Cholesterol:HDL ratio* LDL cholesterol (LDL)* * calculated result

15 Calculated lipids Cholesterol:HDL ratio = (TC/HDL) Used in QRISK 2 risk calculator LDL cholesterol = TC HDL (TG/2.17) Requires a fasting specimen Not valid if TG > 4.5 mmol/l

16 NICE CG181 (2014) Cardiovascular disease: risk assessment and reduction, including lipid modification Before starting lipid modification therapy for the primary prevention of CVD take at least one lipid sample to measure a full lipid profile. This should include measurement of total cholesterol, HDL cholesterol, non HDL cholesterol and triglyceride concentrations. A fasting sample is not needed. [new 2014]

17 Lipid profile from June 2015 Cholesterol l Triglyceride HDL Cholesterol Non HDL Cholesterol* Cholesterol:HDL ratio* LDL Cholesterol* l* Non HDL cholesterol is reported in accordance with NICE CG 181 (2014). LDL cholesterol may not be valid for non fasting samples. * calculated

18 Non HDL cholesterol Non HDL cholesterol = TC HDL (mmol/l) Used as treatment target Aim for 40% reduction in non HDL cholesterol in primary and secondary prevention (from pre treatment level)

19 When patient must fast for lipids If?familial hypercholesterolaemia (FH) as diagnosis is based on LDL cholesterol If raised triglycerides repeat profile with patient fasting as triglycerides are affected by fasting status

20 Lipid summary Generally no need to fast for lipids Cholesterol:HDL ratio used in QRISK 2 Non HDL cholesterol used for treatment target Beware?FH Fasting if raised triglycerides

21

Clinical Practice Guidelines for Diabetes Management

Clinical Practice Guidelines for Diabetes Management Clinical Practice Guidelines for Diabetes Management Diabetes is a disease in which blood glucose levels are above normal. Over the years, high blood glucose damages nerves and blood vessels, which can

More information

PRESCRIBING GUIDELINES FOR LIPID LOWERING TREATMENTS for SECONDARY PREVENTION

PRESCRIBING GUIDELINES FOR LIPID LOWERING TREATMENTS for SECONDARY PREVENTION Hull & East Riding Prescribing Committee PRESCRIBING GUIDELINES FOR LIPID LOWERING TREATMENTS for SECONDARY PREVENTION For guidance on Primary Prevention please see NICE guidance http://www.nice.org.uk/guidance/cg181

More information

What is the ideal A1C goal for people with diabetes? a) Under 7% b) 6.5% or less c) 4%- 6%

What is the ideal A1C goal for people with diabetes? a) Under 7% b) 6.5% or less c) 4%- 6% A1C Test Quiz: Are You in the Know About the A1C Test? The dreaded A1C test. Twice or more a year, you have to face this "judge" of all you have done the two or three months before. No matter how hard

More information

Understanding diabetes Do the recent trials help?

Understanding diabetes Do the recent trials help? Understanding diabetes Do the recent trials help? Dr Geoffrey Robb Consultant Physician and Diabetologist CMO RGA UK Services and Partnership Assurance AMUS 25 th March 2010 The security of experience.

More information

Guidelines for the management of hypertension in patients with diabetes mellitus

Guidelines for the management of hypertension in patients with diabetes mellitus Guidelines for the management of hypertension in patients with diabetes mellitus Quick reference guide In the Eastern Mediterranean Region, there has been a rapid increase in the incidence of diabetes

More information

www.leicestershirediabetes.org.uk

www.leicestershirediabetes.org.uk www.leicestershirediabetes.org.uk Diabetes Care UHL Haemoglobin A1c Testing (HbA1c) A guide for patients and healthcare professionals Haemoglobin A1c Testing (HbA1c) Introduction The Diabetes Team have

More information

Overdiagnosis and the Epidemic of Pre-Diabetes

Overdiagnosis and the Epidemic of Pre-Diabetes Overdiagnosis and the Epidemic of Pre-Diabetes John S. Yudkin Emeritus Professor of Medicine, University College London Outline The concept of Intermediate Hyperglycaemia - Predicting future diabetes

More information

Nova Scotia Guidelines for Acute Coronary Syndromes (Updating the 2008 Diabetes sections of the Guidelines)

Nova Scotia Guidelines for Acute Coronary Syndromes (Updating the 2008 Diabetes sections of the Guidelines) Cardiovascular Health Nova Scotia Guideline Update Nova Scotia Guidelines for Acute Coronary Syndromes (Updating the 2008 Diabetes sections of the Guidelines) Authors: Dr. M. Love, Kathy Harrigan Reviewers:

More information

Article. Heart health and cholesterol levels of Canadians, 2007 to 2009. Component of Statistics Canada Catalogue no. 82-625-X Health Fact Sheets

Article. Heart health and cholesterol levels of Canadians, 2007 to 2009. Component of Statistics Canada Catalogue no. 82-625-X Health Fact Sheets Component of Statistics Canada Catalogue no. 82-625-X Health Fact Sheets Article Heart health and cholesterol levels of Canadians, 2007 to 2009 March How to obtain more information For information about

More information

Prevention of and the Screening for Diabetes Part I Insulin Resistance By James L. Holly, MD Your Life Your Health The Examiner January 19, 2012

Prevention of and the Screening for Diabetes Part I Insulin Resistance By James L. Holly, MD Your Life Your Health The Examiner January 19, 2012 Prevention of and the Screening for Diabetes Part I Insulin Resistance By James L. Holly, MD Your Life Your Health The Examiner January 19, 2012 In 2002, SETMA began a relationship with Joslin Diabetes

More information

Nutrition Therapy in Diabetes Mellitus. Dorothy Debrah Diabetes Specialist Dietitian University Hospital, Llandough. Wales, UK February 2012

Nutrition Therapy in Diabetes Mellitus. Dorothy Debrah Diabetes Specialist Dietitian University Hospital, Llandough. Wales, UK February 2012 Nutrition Therapy in Diabetes Mellitus. Dorothy Debrah Diabetes Specialist Dietitian University Hospital, Llandough. Wales, UK February 2012 University Hospital Llandough DIABETES MELLITUS. Definition:

More information

Diabetes and Stroke. Understanding the connection between diabetes and the increased risk of stroke

Diabetes and Stroke. Understanding the connection between diabetes and the increased risk of stroke Diabetes and Stroke Understanding the connection between diabetes and the increased risk of stroke Make the Connection Almost 26 million people in the U.S. roughly 8 percent of the population have diabetes.

More information

Insulin Resistance and PCOS: A not uncommon reproductive disorder

Insulin Resistance and PCOS: A not uncommon reproductive disorder Insulin Resistance and PCOS: A not uncommon reproductive disorder Joyce L. Ross, MSN, CRNP, CS, FNLA, FPCNA Diplomate Accrediation Council for Clinical Lipidology President Preventive Cardiovascular Nurses

More information

Diagnosing Diabetes. Authors Dr Susan Arnott Lead Clinician, Diabetes MCN Lanarkshire

Diagnosing Diabetes. Authors Dr Susan Arnott Lead Clinician, Diabetes MCN Lanarkshire Diagnosing Diabetes Definition of Diabetes Mellitus The World Health Organisation (WHO) defines diabetes as a metabolic disorder of multiple aetiology, characterised by chronic hyperglycaemia with disturbances

More information

MY TYPE 2 DIABETES NUMBERS

MY TYPE 2 DIABETES NUMBERS BLOOD SUGAR MANAGEMENT GUIDE MY TYPE 2 DIABETES NUMBERS Understanding and Tracking the ABCs of Type 2 Diabetes 1 BLOOD MY TYPE SUGAR 2 DIABETES MANAGEMENT ABC NUMBERS GUIDE When you have type 2 diabetes,

More information

Chronic Kidney Disease (CKD)Management in General Practice SUMMARY GUIDE

Chronic Kidney Disease (CKD)Management in General Practice SUMMARY GUIDE Chronic Kidney Disease (CKD)Management in General Practice SUMMARY GUIDE Early detection of CKD using kidney health check Who is at higher risk of kidney disease? Age > 50 years Diabetes High blood pressure

More information

PPS UNDERWRITING GUIDE FOR APPLICANTS

PPS UNDERWRITING GUIDE FOR APPLICANTS PPS UNDERWRITING GUIDE FOR APPLICANTS UNDERWRITING guide 2013 WHAT HAPPENS WHEN YOU SUBMIT YOUR APPLICATION FOR INSURANCE? Once an application is submitted it is put through a number of processes to ensure

More information

An important first step in identifying those at risk for Cardiovascular disease The Accutrend Plus system: from the makers of the ACCU-CHEK and

An important first step in identifying those at risk for Cardiovascular disease The Accutrend Plus system: from the makers of the ACCU-CHEK and An important first step in identifying those at risk for Cardiovascular disease The Accutrend Plus system: from the makers of the ACCU-CHEK and CoaguChek systems Cardiovascular disease: the #1 killer in

More information

CLINICAL PRACTICE GUIDELINE

CLINICAL PRACTICE GUIDELINE CLINICAL PRACTICE GUIDELINE Procedure: Diabetes Guideline Review Cycle: Biennial Reviewed By: Amish Purohit, MD, MHA, CPE, FACHE Review Date: November 2014 Committee Approval Date: 11/12/2014 PURPOSE:

More information

Is Insulin Effecting Your Weight Loss and Your Health?

Is Insulin Effecting Your Weight Loss and Your Health? Is Insulin Effecting Your Weight Loss and Your Health? Teressa Alexander, M.D., FACOG Women s Healthcare Associates www.rushcopley.com/whca 630-978-6886 Obesity is Epidemic in the US 2/3rds of U.S. adults

More information

Overview and update of modern type 2 Diabetes philosophy and management. Dr Steve Stanaway Consultant Endocrinologist BCU

Overview and update of modern type 2 Diabetes philosophy and management. Dr Steve Stanaway Consultant Endocrinologist BCU Overview and update of modern type 2 Diabetes philosophy and management Dr Steve Stanaway Consultant Endocrinologist BCU Diabetes economics 2009: 2.6M adults with DM in UK (90% type 2) 2025: est. > 4M

More information

Examination. Sample. Adult- Yellow top. Sample Tube/Container

Examination. Sample. Adult- Yellow top. Sample Tube/Container Examination 17749 Protein Electrophoresis (Total protein, albumin, Bence jones protein, serum protein electrophoresis SPE, myeloma, and other B cell dyscrasias screen) Purpose of test The main reasons

More information

TYPE 2 DIABETES MELLITUS: NEW HOPE FOR PREVENTION. Robert Dobbins, M.D. Ph.D.

TYPE 2 DIABETES MELLITUS: NEW HOPE FOR PREVENTION. Robert Dobbins, M.D. Ph.D. TYPE 2 DIABETES MELLITUS: NEW HOPE FOR PREVENTION Robert Dobbins, M.D. Ph.D. Learning Objectives Recognize current trends in the prevalence of type 2 diabetes. Learn differences between type 1 and type

More information

Causes, incidence, and risk factors

Causes, incidence, and risk factors Causes, incidence, and risk factors Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes,

More information

Diabetes in Primary Care course MCQ Answers 2016

Diabetes in Primary Care course MCQ Answers 2016 Diabetes in Primary Care course MCQ Answers 2016 Diagnosis of Diabetes HbA1C should not be used as a diagnostic tool in the following situations: (answer each TRUE or FALSE) 1. Gestational Diabetes TRUE

More information

1. PATHOPHYSIOLOGY OF METABOLIC SYNDROME

1. PATHOPHYSIOLOGY OF METABOLIC SYNDROME 1. PATHOPHYSIOLOGY OF METABOLIC SYNDROME Izet Aganović, Tina Dušek Department of Internal Medicine, Division of Endocrinology, University Hospital Center Zagreb, Croatia 1 Introduction The metabolic syndrome

More information

REACH Risk Evaluation to Achieve Cardiovascular Health

REACH Risk Evaluation to Achieve Cardiovascular Health Dyslipidemia and obesity History: A 13-year-old girl is seen for a routine clinic follow-up visit. She has been previously healthy, but her growth curve shows increasing body mass index (BMI) percentiles

More information

The A1C Test and Diabetes

The A1C Test and Diabetes The A1C Test and Diabetes National Diabetes Information Clearinghouse What is the A1C test? The A1C test is a blood test that provides information about a person s average levels of blood glucose, also

More information

Diabetes, Type 2. RelayClinical Patient Education Sample Topic Diabetes, Type 2. What is type 2 diabetes? How does it occur?

Diabetes, Type 2. RelayClinical Patient Education Sample Topic Diabetes, Type 2. What is type 2 diabetes? How does it occur? What is type 2 diabetes? Type 2 diabetes is a disorder that happens when your body does not make enough insulin or is unable to use its own insulin properly. The inability to use insulin is called insulin

More information

Insulin Resistance and Pre-diabetes

Insulin Resistance and Pre-diabetes 1 of 6 11/17/2009 9:38 PM Insulin Resistance and Pre-diabetes What is insulin resistance? What causes insulin resistance? Metabolic Syndrome What is pre-diabetes? What are the symptoms of insulin resistance

More information

ADVANCE: a factorial randomised trial of blood pressure lowering and intensive glucose control in 11,140 patients with type 2 diabetes

ADVANCE: a factorial randomised trial of blood pressure lowering and intensive glucose control in 11,140 patients with type 2 diabetes ADVANCE: a factorial randomised trial of blood pressure lowering and intensive glucose control in 11,140 patients with type 2 diabetes Effects of a fixed combination of the ACE inhibitor, perindopril,

More information

DISCLOSURES RISK ASSESSMENT. Stroke and Heart Disease -Is there a Link Beyond Risk Factors? Daniel Lackland, MD

DISCLOSURES RISK ASSESSMENT. Stroke and Heart Disease -Is there a Link Beyond Risk Factors? Daniel Lackland, MD STROKE AND HEART DISEASE IS THERE A LINK BEYOND RISK FACTORS? D AN IE L T. L AC K L AN D DISCLOSURES Member of NHLBI Risk Assessment Workgroup RISK ASSESSMENT Count major risk factors For patients with

More information

Health and lifestyles of people aged 50 and over

Health and lifestyles of people aged 50 and over NC457_Elsa Nurse leaflet A5_NC457_Elsa Nurse leaflet A5 16/04/2012 16:18 Page 1 English Longitudinal Study of Ageing Health and lifestyles of people aged 50 and over This leaflet tells you more about the

More information

Department Of Biochemistry. Subject: Diabetes Mellitus. Supervisor: Dr.Hazim Allawi & Dr.Omar Akram Prepared by : Shahad Ismael. 2 nd stage.

Department Of Biochemistry. Subject: Diabetes Mellitus. Supervisor: Dr.Hazim Allawi & Dr.Omar Akram Prepared by : Shahad Ismael. 2 nd stage. Department Of Biochemistry Subject: Diabetes Mellitus Supervisor: Dr.Hazim Allawi & Dr.Omar Akram Prepared by : Shahad Ismael. 2 nd stage. Diabetes mellitus : Type 1 & Type 2 What is diabestes mellitus?

More information

Protein Intake in Potentially Insulin Resistant Adults: Impact on Glycemic and Lipoprotein Profiles - NPB #01-075

Protein Intake in Potentially Insulin Resistant Adults: Impact on Glycemic and Lipoprotein Profiles - NPB #01-075 Title: Protein Intake in Potentially Insulin Resistant Adults: Impact on Glycemic and Lipoprotein Profiles - NPB #01-075 Investigator: Institution: Gail Gates, PhD, RD/LD Oklahoma State University Date

More information

Glucose (Blood, serum, plasma)

Glucose (Blood, serum, plasma) Glucose (Blood, serum, plasma) 1 Name and description of analyte 1.1 Name of analyte Glucose (plasma; also blood, serum) 1.2 Alternative names None, though when used therapeutically, glucose is often referred

More information

Initiate Atorvastatin 20mg daily

Initiate Atorvastatin 20mg daily Type 2 Diabetes Patient Objectives Stopping Smoking BMI > 25 kg m² Control BP to

More information

G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 1

G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 1 G:\ CDM\BHCIG Diabetes Pathway FINAL September 05.doc 1 BHCiG: TYPE 2 DIABETES MANAGEMENT PATHWAY MODEL INTRODUCTION What is the aim of the model? To improve the capacity of primary care health practitioners

More information

Visual Acuity. Hearing. Height and Weight. Blood Pressure MEASURED VALUE

Visual Acuity. Hearing. Height and Weight. Blood Pressure MEASURED VALUE TEST ITEM DESCRIPTION STANDARD LEVEL Standard level varies among different examination methods. Please check with your medical facility about normal level. MEASURED VALUE Visual Acuity You look at rings

More information

Evaluation of Non-HDL-Cholesterol/HDL-cholesterol ratio as a predictor of coronary artery disease

Evaluation of Non-HDL-Cholesterol/HDL-cholesterol ratio as a predictor of coronary artery disease Journal homepage: http://www.journalijar.com INTERNATIONAL JOURNAL OF ADVANCED RESEARCH RESEARCH ARTICLE Evaluation of Non-HDL-Cholesterol/HDL-cholesterol ratio as a predictor of coronary artery disease

More information

Definitions. Disclaimer

Definitions. Disclaimer Lab Testing Worksheets / Page 2 Definitions s refer to the laboratory values that are generally associated with absence of disease. Values higher or lower indicate deviation from the standard norm and

More information

Blood Glucose Control. What's covered in these pages

Blood Glucose Control. What's covered in these pages Blood Glucose Control Diabetes makes many demands on the individual, not least of which is the need for frequent testing of blood glucose levels. In the early days, blood glucose testing was usually advised

More information

Improving cardiometabolic health in Major Mental Illness

Improving cardiometabolic health in Major Mental Illness Improving cardiometabolic health in Major Mental Illness Dr. Adrian Heald Consultant in Endocrinology and Diabetes Leighton Hospital, Crewe and Macclesfield Research Fellow, Manchester University Metabolic

More information

Nutrition: Knowing Your Total Cholesterol

Nutrition: Knowing Your Total Cholesterol Nutrition: Knowing Your Total Cholesterol A number of factors can increase your risk for coronary heart disease. To make an accurate assessment your doctor will determine your lipid profile, overall health,

More information

嘉 義 長 庚 醫 院 藥 劑 科 Speaker : 翁 玟 雯

嘉 義 長 庚 醫 院 藥 劑 科 Speaker : 翁 玟 雯 The Clinical Efficacy and Safety of Sodium Glucose Cotransporter-2 (SGLT2) Inhibitors in Adults with Type 2 Diabetes Mellitus 嘉 義 長 庚 醫 院 藥 劑 科 Speaker : 翁 玟 雯 Diabetes Mellitus : A group of diseases characterized

More information

An International Atherosclerosis Society Position Paper: Global Recommendations for the Management of Dyslipidemia

An International Atherosclerosis Society Position Paper: Global Recommendations for the Management of Dyslipidemia An International Atherosclerosis Society Position Paper: Global Recommendations for the Management of Dyslipidemia Introduction Executive Summary The International Atherosclerosis Society (IAS) here updates

More information

MEDICAL NUTRITION THERAPY (MNT) CLINICAL NUTRITION THERAPY Service Time CPT Code

MEDICAL NUTRITION THERAPY (MNT) CLINICAL NUTRITION THERAPY Service Time CPT Code MEDICAL NUTRITION THERAPY (MNT) CLINICAL NUTRITION THERAPY Service Time CPT Code Initial Assessment And Intervention This Code Can Be Used Only Once A Year For First Appointment Medical Nutrition Therapy

More information

ICD 10 CM. Diabetes Mellitus Hypertension

ICD 10 CM. Diabetes Mellitus Hypertension ICD 10 CM Diabetes Mellitus Hypertension 1 Legal Stuff The information provided here is personal opinion only and should not be construed as legal advice. Each provider is ultimately responsible for bills

More information

Population Health Management Program

Population Health Management Program Population Health Management Program Program (formerly Disease Management) is dedicated to improving our members health and quality of life. Our Population Health Management Programs aim to improve care

More information

Statins and Risk for Diabetes Mellitus. Background

Statins and Risk for Diabetes Mellitus. Background Statins and Risk for Diabetes Mellitus Kevin C. Maki, PhD, FNLA Midwest Center for Metabolic & Cardiovascular Research and DePaul University, Chicago, IL 1 Background In 2012 the US Food and Drug Administration

More information

PARTI: HOW TO IMPORT A CUSTOM EXAM TEMPLATE FOR TOP ASaP PARTICIPATION

PARTI: HOW TO IMPORT A CUSTOM EXAM TEMPLATE FOR TOP ASaP PARTICIPATION PARTI: HOW TO IMPORT A CUSTOM EXAM TEMPLATE FOR TOP ASaP PARTICIPATION 1. Login to your Wolf EMR. 2. Open Internet Explorer 3. Go the TOP ASaP web site to the EMR Knowledge Resources area at: http://www.topalbertadoctors.org/asap/resourcestools/emrkt/

More information

Know your Numbers The D5 Goals for Diabetes Care. Shelly Hanson RN, CNS, CDE Cuyuna Regional Medical Center November 6, 2014

Know your Numbers The D5 Goals for Diabetes Care. Shelly Hanson RN, CNS, CDE Cuyuna Regional Medical Center November 6, 2014 Know your Numbers The D5 Goals for Diabetes Care Shelly Hanson RN, CNS, CDE Cuyuna Regional Medical Center November 6, 2014 The D5 What is it 5 different treatment goals identified for optimal diabetes

More information

YOUR GUIDE TO. Lowering The Risk of Heart Attack and Stroke

YOUR GUIDE TO. Lowering The Risk of Heart Attack and Stroke YOUR GUIDE TO Lowering The Risk of Heart Attack and Stroke The Mercy Health Heart Institute team is focused on helping you keep your heart healthy. As part of this effort, it s important for you to know

More information

PowerPoint Lecture Outlines prepared by Dr. Lana Zinger, QCC CUNY. 12a. FOCUS ON Your Risk for Diabetes. Copyright 2011 Pearson Education, Inc.

PowerPoint Lecture Outlines prepared by Dr. Lana Zinger, QCC CUNY. 12a. FOCUS ON Your Risk for Diabetes. Copyright 2011 Pearson Education, Inc. PowerPoint Lecture Outlines prepared by Dr. Lana Zinger, QCC CUNY 12a FOCUS ON Your Risk for Diabetes Your Risk for Diabetes! Since 1980,Diabetes has increased by 50 %. Diabetes has increased by 70 percent

More information

Metabolic Syndrome Overview: Easy Living, Bitter Harvest. Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007

Metabolic Syndrome Overview: Easy Living, Bitter Harvest. Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007 Metabolic Syndrome Overview: Easy Living, Bitter Harvest Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007 Evolution of Metabolic Syndrome 1923: Kylin describes clustering

More information

Prevention of Cardiovascular Disease in Children with Diabetes

Prevention of Cardiovascular Disease in Children with Diabetes Prevention of Cardiovascular Disease in Children with Diabetes Stephen R. Daniels, MD, PhD Department of Pediatrics University of Colorado School of Medicine The Children s Hospital Anschutz Medical Campus

More information

NZSSD Position Statement on the diagnosis of, and screening for, Type 2 Diabetes

NZSSD Position Statement on the diagnosis of, and screening for, Type 2 Diabetes NZSSD Position Statement on the diagnosis of, and screening for, Type 2 Diabetes Updated: September 2011 This 2011 statement is a guide for health practitioners and complements 2003 and 2009 formal guidelines

More information

INSULIN RESISTANCE, POLYCYSTIC OVARIAN SYNDROME

INSULIN RESISTANCE, POLYCYSTIC OVARIAN SYNDROME 1 University of Papua New Guinea School of Medicine and Health Sciences Division of Basic Medical Sciences Discipline of Biochemistry and Molecular Biology PBL SEMINAR INSULIN RESISTANCE, POLYCYSTIC OVARIAN

More information

Know Your Resistance A Guide to Better Health

Know Your Resistance A Guide to Better Health Know Your Resistance A Guide to Better Health This material is copyrighted by Bayer HealthCare LLC and is intended solely for use in the Know Your Series educational programs supported by Bayer HealthCare

More information

Ahmed Saeed Ibrahim. M.D., Ph. D. Researcher of Ophthalmology National Research Center -Cairo

Ahmed Saeed Ibrahim. M.D., Ph. D. Researcher of Ophthalmology National Research Center -Cairo Association of Single Nucleotide olymorphism in -46and +45 of Vascular Endothelial Growth Factor Gene with the Development of roliferative Diabetic Retinopathy in Type 2 Diabetes Mellitus Ahmed Saeed Ibrahim

More information

CLINICAL GUIDELINE FOR THE MANAGEMENT OF HYPERGLYCAEMIA IN ADULTS WITH ACUTE CORONARY SYNDROME

CLINICAL GUIDELINE FOR THE MANAGEMENT OF HYPERGLYCAEMIA IN ADULTS WITH ACUTE CORONARY SYNDROME CLINICAL GUIDELINE FOR THE MANAGEMENT OF HYPERGLYCAEMIA IN ADULTS WITH ACUTE CORONARY SYNDROME 1. Aim/Purpose of this Guideline This guideline is for the management of Adult patients with Diabetes Mellitus

More information

Scottish Diabetes Survey 2014. Scottish Diabetes Survey Monitoring Group

Scottish Diabetes Survey 2014. Scottish Diabetes Survey Monitoring Group Scottish Diabetes Survey 2014 Scottish Diabetes Survey Monitoring Group Contents Table of Contents Contents... 2 Foreword... 4 Executive Summary... 6 Prevalence... 8 Undiagnosed diabetes... 21 Duration

More information

WHAT IS DIABETES MELLITUS? CAUSES AND CONSEQUENCES. Living your life as normal as possible

WHAT IS DIABETES MELLITUS? CAUSES AND CONSEQUENCES. Living your life as normal as possible WHAT IS DIABETES MELLITUS? CAUSES AND CONSEQUENCES DEDBT01954 Lilly Deutschland GmbH Werner-Reimers-Straße 2-4 61352 Bad Homburg Living your life as normal as possible www.lilly-pharma.de www.lilly-diabetes.de

More information

Your healthcare provider has ordered a Boston Heart Cardiac Risk Assessment

Your healthcare provider has ordered a Boston Heart Cardiac Risk Assessment Your healthcare provider has ordered a Boston Heart Cardiac Risk Assessment What does that mean for you? Your healthcare provider has determined that you may be at risk for cardiovascular disease (CVD).

More information

Contractor Information. LCD Information. Local Coverage Determination (LCD): HbA1c (L32939) Contract Number 11202

Contractor Information. LCD Information. Local Coverage Determination (LCD): HbA1c (L32939) Contract Number 11202 Local Coverage Determination (LCD): HbA1c (L32939) Contractor Information Contractor Name Palmetto GBA opens in new window Contract Number 11202 Contract Type MAC - Part B LCD Information Document Information

More information

The Freiburg Study. Preliminary Findings

The Freiburg Study. Preliminary Findings The Freiburg Study Preliminary Findings Free Radicals and Oxygen Metabolism MItochondrial Free Radicals Inflammation (hs-crp) Blood Lipids (Cholesterol, Triglycerides) Blood Pressure (Systolic, Diastolic,

More information

Southern Derbyshire Shared Care Pathology Guidelines. Hyponatraemia in Adults

Southern Derbyshire Shared Care Pathology Guidelines. Hyponatraemia in Adults Southern Derbyshire Shared Care Pathology Guidelines Hyponatraemia in Adults Purpose of Guideline The investigation and management of adult patients with newly diagnosed hyponatraemia. Hyponatraemia can

More information

WHAT CAN I DO TO REDUCE MY RISK OF DEVELOPING THE COMPLICATIONS OF TYPE 1 DIABETES?

WHAT CAN I DO TO REDUCE MY RISK OF DEVELOPING THE COMPLICATIONS OF TYPE 1 DIABETES? Christian In better control with his pump since 2012 WHAT CAN I DO TO REDUCE MY RISK OF DEVELOPING THE COMPLICATIONS OF TYPE 1 DIABETES? Many people with Type 1 diabetes worry about potential long-term

More information

Connecticut Diabetes Statistics

Connecticut Diabetes Statistics Connecticut Diabetes Statistics What is Diabetes? State Public Health Actions (1305, SHAPE) Grant March 2015 Page 1 of 16 Diabetes is a disease in which blood glucose levels are above normal. Blood glucose

More information

Anaemia Patient information

Anaemia Patient information Anaemia Patient information What is anaemia? Anaemia is the result of either not having enough red cells to take oxygen around the body, or having faulty red cells that are unable to carry enough oxygen.

More information

Data, Outcomes and Population Health Management. CPPEG January 2016

Data, Outcomes and Population Health Management. CPPEG January 2016 Data, Outcomes and Population Health Management CPPEG January 216 NHS Outcomes Framework There are national outcome measures which the CCG is held to account on. In conjunction to monitoring these the

More information

Hôpitaux Universitaires de Genève Lipides, métabolisme des hydrates de carbonne et maladies cardio-vasculaires

Hôpitaux Universitaires de Genève Lipides, métabolisme des hydrates de carbonne et maladies cardio-vasculaires Hôpitaux Universitaires de Genève Lipides, métabolisme des hydrates de carbonne et maladies cardio-vasculaires Prof. J. Philippe Effect of estrogens on glucose metabolism : Fasting Glucose, HbA1c and C-Peptide

More information

Diabetes and Heart Disease

Diabetes and Heart Disease Diabetes and Heart Disease Diabetes and Heart Disease According to the American Heart Association, diabetes is one of the six major risk factors of cardiovascular disease. Affecting more than 7% of the

More information

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic.

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic. bring together all NICE guidance, quality standards and other NICE information on a specific topic. are interactive and designed to be used online. They are updated regularly as new NICE guidance is published.

More information

INSURANCE TEST AND TUBE INFORMATION

INSURANCE TEST AND TUBE INFORMATION HIV Cotinine TPHA RPR and VDRL Hep. B s Antigen Hep. C Antibodies Cholesterol Triglyceride HDL Cholesterol Creatinine Urea Uric acid This is a screening test to detect HIV infection. The test does not

More information

METABOLIC SYNDROME. Rebecca Rovay-Hazelton, Licensed Nutritionist

METABOLIC SYNDROME. Rebecca Rovay-Hazelton, Licensed Nutritionist METABOLIC SYNDROME Rebecca Rovay-Hazelton, Licensed Nutritionist Blood Sugar Basics Glucose=a simple sugar used for energy from diet, primarily starches, sugar and carbohydrate Insulin=a hormone made in

More information

What do you know about HbA1C

What do you know about HbA1C Did you know? Essential advice for people with diabetes from Accu-Chek HbA1C is a measure of your average blood glucose level over 3 months Your HbA1C target should be under 53mmol/mol It is important

More information

Type 2 Diabetes workshop notes

Type 2 Diabetes workshop notes Group 1 notes Abi / Nicole Type 2 Diabetes workshop notes 4.1 Population The group discussed the following sub groups that may need addressing: Men-as they tend to die earlier compared with women, their

More information

Body Composition & Longevity. Ohan Karatoprak, MD, AAFP Clinical Assistant Professor, UMDNJ

Body Composition & Longevity. Ohan Karatoprak, MD, AAFP Clinical Assistant Professor, UMDNJ Body Composition & Longevity Ohan Karatoprak, MD, AAFP Clinical Assistant Professor, UMDNJ LONGEVITY Genetic 25% Environmental Lifestyle Stress 75% BMI >30 OBESE 25-30 OVERWEIGHT 18-25 NORMAL WEIGHT 18

More information

David Shu, MD, FRCPC Endocrinology, Royal Columbian Hospital October 8 th, 2010

David Shu, MD, FRCPC Endocrinology, Royal Columbian Hospital October 8 th, 2010 David Shu, MD, FRCPC Endocrinology, Royal Columbian Hospital October 8 th, 2010 Objectives At the end of the talk, the participants will be able to: 1. Identify the increasing prevalence of type 2 diabetes

More information

Blood clot in atheroma. help make vitamin D and hormones, like oestrogen and testosterone, in your body.

Blood clot in atheroma. help make vitamin D and hormones, like oestrogen and testosterone, in your body. CHOLESTEROL This factsheet explains what cholesterol is and why too much cholesterol in your blood is harmful. It also provides information regarding cholesterol testing and tips to help reduce your blood

More information

Education. Panel. Triglycerides & HDL-C

Education. Panel. Triglycerides & HDL-C Triglycerides & HDL-C Thomas Dayspring, MD, ACP Clinical Assistant Professor of Medicine University of Medicine and Dentistry of New Jersey Attending in Medicine: St Joseph s s Hospital, Paterson, NJ Certified

More information

Diabetes 101: A Brief Overview of Diabetes and the American Diabetes Association What Happens When We Eat?

Diabetes 101: A Brief Overview of Diabetes and the American Diabetes Association What Happens When We Eat? Diabetes 101: A Brief Overview of Diabetes and the American Diabetes Association What Happens When We Eat? After eating, most food is turned into glucose, the body s main source of energy. 1 Normal Blood

More information

Antipsychotic Medications and the Risk of Diabetes and Cardiovascular Disease

Antipsychotic Medications and the Risk of Diabetes and Cardiovascular Disease Antipsychotic Medications and the Risk of Diabetes and Cardiovascular Disease Patient Tool #1 Understanding Diabetes and Psychiatric Illness: A Guide for Individuals, Families, and Caregivers Type 2 Diabetes,

More information

Freiburg Study. The other 24 subjects had healthy markers closer to what would be considered ideal.

Freiburg Study. The other 24 subjects had healthy markers closer to what would be considered ideal. Freiburg Study The Freiburg Study was conducted with 48 healthy human subjects of various ages. None of the test subjects had been diagnosed with any disease prior to the study. None were taking any type

More information

HEDIS CY2012 New Measures

HEDIS CY2012 New Measures HEDIS CY2012 New Measures TECHNICAL CONSIDERATIONS FOR NEW MEASURES The NCQA Committee on Performance Measurement (CPM) approved five new measures for HEDIS 2013 (CY2012). These measures provide feasible

More information

Metabolic Syndrome with Prediabetic Factors Clinical Study Summary Concerning the Efficacy of the GC Control Natural Blood Sugar Support Supplement

Metabolic Syndrome with Prediabetic Factors Clinical Study Summary Concerning the Efficacy of the GC Control Natural Blood Sugar Support Supplement CLINICALLY T E S T E D Natural Blood Sugar Metabolic Syndrome with Prediabetic Factors Clinical Study Summary Concerning the Efficacy of the GC Control Natural Blood Sugar Metabolic Syndrome with Prediabetic

More information

The Well Man Package is a comprehensive package designed to assure a healthy life for males, at different age levels.

The Well Man Package is a comprehensive package designed to assure a healthy life for males, at different age levels. WELL MAN PACKAGES The Well Man Package is a comprehensive package designed to assure a healthy life for males, at different age levels. ELECTROCARDIOGRAM WITH SHORT RHYTHM TEST ECG A test to measure the

More information

Chapter 7: Strengthen the Role & Impact of Ill Health Prevention Diabetes

Chapter 7: Strengthen the Role & Impact of Ill Health Prevention Diabetes Chapter 7: Strengthen the Role & Impact of Ill Health Prevention Diabetes Lead author: Dr Sapna Chauhan Introduction Diabetes is a major public health issue. There are currently around 3.8 million people

More information

MANAGEMENT OF LIPID DISORDERS: IMPLICATIONS OF THE NEW GUIDELINES

MANAGEMENT OF LIPID DISORDERS: IMPLICATIONS OF THE NEW GUIDELINES MANAGEMENT OF LIPID DISORDERS: IMPLICATIONS OF THE NEW GUIDELINES Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Declaration of full disclosure: No conflict of interest EXPLAINING

More information

Guideline for Microalbuminuria Screening

Guideline for Microalbuminuria Screening East Lancashire Diabetes Network Guideline for Microalbuminuria Screening Produced by: Task and Finish Group, Clinical Standards Group Produced: August 2006 Approved by: East Lancashire Diabetes Network

More information

Blood Transfusion. There are three types of blood cells: Red blood cells. White blood cells. Platelets.

Blood Transfusion. There are three types of blood cells: Red blood cells. White blood cells. Platelets. Blood Transfusion Introduction Blood transfusions can save lives. Every second, someone in the world needs a blood transfusion. Blood transfusions can replace the blood lost from a serious injury or surgery.

More information

Renal Disease in Type 2 Diabetes Mellitus

Renal Disease in Type 2 Diabetes Mellitus Renal Disease in Type 2 Diabetes Mellitus 6th Collaborative DiGP/HSE/UCC Conference 25 th September 2013 Dr. Eoin O Sullivan Consultant Endocrinologist Bon Secours Hospital Cork Case 69 year old woman

More information

DR. Trinh Thi Kim Hue

DR. Trinh Thi Kim Hue TYPE 2 DIABETES IN THE CHILD AND ADOLESCENT DR. Trinh Thi Kim Hue CONTENTS Definition Diagnosis Treatment Comorbidities and Complications Comorbidities and Complications Screening for T2D References DEFINITION

More information

Blood Testing Protocols. Disclaimer

Blood Testing Protocols. Disclaimer Blood Testing Protocols / Page 2 Blood Testing Protocols Here are the specific test protocols recommend by Dr. J.E. Williams. You may request these from your doctor or visit www.readyourbloodtest.com to

More information

How Do I Know The Pauling Therapy Is Working? And, How Long Will It Take?

How Do I Know The Pauling Therapy Is Working? And, How Long Will It Take? How Do I Know The Pauling Therapy Is Working? And, How Long Will It Take? These are the 2 questions my customers ask most often. These are also the 2 questions that are the hardest to answer. So, I have

More information

TERMS FOR UNDERSTANDING YOUR TYPE 2 DIABETES. Definitions for Common Terms Related to Type 2 Diabetes

TERMS FOR UNDERSTANDING YOUR TYPE 2 DIABETES. Definitions for Common Terms Related to Type 2 Diabetes TERMS FOR UNDERSTANDING YOUR TYPE 2 DIABETES Definitions for Common Terms Related to Type 2 Diabetes TYPE 2 DIABETES AND BLOOD SUGAR 1-3 This list of terms may help you beter understand type 2 diabetes,

More information

1.5 Function of analyte For albumin, see separate entry. The immunoglobulins are components of the humoral arm of the immune system.

1.5 Function of analyte For albumin, see separate entry. The immunoglobulins are components of the humoral arm of the immune system. Total protein (serum, plasma) 1 Name and description of analyte 1.1 Name of analyte Total protein 1.2 Alternative names None 1.3 NMLC code 1.4 Description of analyte This is a quantitative measurement

More information

Barriers to Healthcare Services for People with Mental Disorders. Cardiovascular disorders and diabetes in people with severe mental illness

Barriers to Healthcare Services for People with Mental Disorders. Cardiovascular disorders and diabetes in people with severe mental illness Barriers to Healthcare Services for People with Mental Disorders Cardiovascular disorders and diabetes in people with severe mental illness Dr. med. J. Cordes LVR- Klinikum Düsseldorf Kliniken der Heinrich-Heine-Universität

More information

Laboratory Monitoring of Adult Hospital Patients Receiving Parenteral Nutrition

Laboratory Monitoring of Adult Hospital Patients Receiving Parenteral Nutrition Laboratory Monitoring of Adult Hospital Patients Receiving Parenteral Nutrition Copy 1 Location of copies Web based only The following guideline is for use by medical staff caring for the patient and members

More information