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Spot check your memory for these disease details.
1. Data support referring a patient wtih type 2 diabetes for weight loss surgery at a BMI of:
A. ≥25 kg/m2
B. ≥30 kg/m2
C. ≥35 kg/m2
D. ≥40 kg/m2
Answer: C. ≥ 35 kg/m2
National guidelines support referring patients with type 2 diabetes for bariatric surgery when the BMI ≥35 kg/m2. This is particularly true if the diabetes cannot be adequately controlled through lifestyle modifications and medications. There is insufficient evidence to refer diabetic patients with a BMI <35 kg/m2 and this needs to be assessed on case by case basis.
2. Which of the following is true regarding gestational diabetes?
A. It occurs in 1% of all pregnancies
B. Age >30 years is a risk factor
C. After delivery, there is no increased risk for developing type 2 diabetes
D. First-line treatment includes oral hypoglycemic
Answer: B. Age >30 years is a risk factor
Gestational diabetes is defined as glucose intolerance which develops during pregnancy. It is estimated to affect approximately 10% of all pregnancies, and this may be an underestimate of its true prevalence. Several risk factors have been identified, including age >30 years, obesity, and family history of diabetes. It can cause several complications after delivery to both mother and child. Mothers have an increased risk of developing metabolic syndrome and type 2 diabetes. First-line treatment includes diet and exercise. If these measures fail, then oral hypoglycemics or insulin can be used for glycemic control.
3. Screening for serum levels of which of the following should be considered after a diagnosis of type 1 diabetes in a child?
A. Transglutaminase (TTG) IgA
Answer: A. TTG IgA
There is an association between type 1 diabetes and celiac disease. The prevalence of celiac disease in diabetes is up to 16% compared with approximately 1% in the general population. Measuring serum levels of tissue transglutaminase (TTG) is an excellent method for initial screening of celiac disease. If positive, referral to a gastroenterologist for duodenal biopsies can confirm the diagnosis. Levels of anti-Scl-70 indicate scleroderma; ASMA is a marker for autoimmune hepatitis; and ANA is a nonspecific marker for autoimmune conditions such as lupus. These 3 serum tests are not routinely recommended after a diagnosis of type 1 diabetes.