Recheck diabetic parameters

[Guest guest]

the sugar parameters you have in your sheet are too high; they've been lowered. LL Egly wrote: Great Check Out Sheet. Consider LDL less than 70 as new guidelines for patients with known CAD after treatment,bypass or angioplasty, had 50% fewer events in follow up than when treated to LDL 100. I use to treat all diabetics assuming they had heart disease to LDL 100. I now

extrapolate the cardiovascular data to my diabetics because we assume 50 % of diabetics at diagnosis have undiagnosed heart disease. I also believe the goals for HDL are reversed in your checkout sheet. Men >45, Women >55. Respectfully yours, PS May use it for my clinic?roxywible <roxywiblecomcast (DOT) net> wrote: Diabetes Care - Meet Your GoalsIt is important to control your cardiovascular (CV) risk factors to prevent stroke, heart attack and "end organ damage." CV risk factors include: (modifiable) high blood pressure, diabetes, smoking, obesity, sedentary and high stress lifestyle, and (unmodifiable) personal/family history. Keep your risk factors

controlled, meet your goals and avoid lengthy doctor visits and hospitalizations. Diabetes is reversible for many people!Understand Your Lab Values:Diagnosing Diabetes: Diabetes Fasting Blood Glucose (FBG) = > 126 Pre-Diabetes = 100-125______________________Self Monitoring Blood Glucose (SMBG): Check a few times a week to daily depending on your situation. With insulin you will need to check up to 3 x daily. Also check if you feel hypoglycemic. *ALWAYS Bring your home SMBG record to each visit* Goal FBG = 90-130 Goal 2 hrs after eating = < 180______________________Glycosylated Hemoglobin (HgA1C): This test reflects your glucose control over the last 3-4 months by measuring the % of hemoglobin molecules in the red blood cells with glucose attached. Goal is < 7% which equals an average BG of 170. ______________________Nephropathy (Kidney Labs): If you have

kidney damage then eating less protein and plant protein (<0.8g/kg) can help slow the progression. Medications called ACEI (ace inhibitors) and others may slow progression. If your GFR is < 30 you should be friends with a local nephrologist.Goals: Serum creatinine (<1.3)___________ Microalbuminuria (< 30 mg)_________________Glomerular Filtration Rate (GFR) > 60. ____________________Lipids: Goal: Fasting Total Chol < 200____________HDL >40 for women, >50 for men____________ LDL < 100_____________ Triglycerides < 150 ___________Blood Pressure: Goal < 130/80 mmHg ________________Health Care Maintenance: complete physical pap mammogram dental exam vision/retinopathy examneuropathy/foot exam blood pressurelabs cholesterol prostate thyroid nephropathy labs HgA1Ccolonoscopy (more fun than it sounds) Immunizations LCPHD

682-4042 Tetanus, Tdap, Influenza yearly , Pneumoccocal (at time of diagnosis and revaccinate once after 5 years if > 65 years old)Aspirin - 81 mg daily if > 30 years oldFollow Up Appointment: _____________________ or please call ___ Uncontrolled Diabetes 1 wk 2 wk 3 wk 4 wk___ Mostly Controlled Diabetes 2 mo 3 mo 4 mo ___ Well Controlled Diabetes 6 mo 12 moPlease ensure you have enough medications until your next visitQuestions? Call Dr. Wible 345-2437 Check out the all-new Yahoo! Mail beta - Fire up a more powerful email and get things done faster.

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[Guest guest]

Diabetic parameters are correct according to UP TO DATE:

Normal FPG is <100 mg/dL (5.6 mmol/L).

IFG is defined as FPG 100 to 125 mg/dL (5.6-6.9 mmol/L).

IGT is defined as 2-h PG 140 mg/dL (7.8 mmol/L) and

<200 mg/dL (11.1 mmol/L).

The criteria for the diagnosis of diabetes are unchanged

(FPG 126 mg/dL (6.9 mmol/L); 2-h PG 200 mg/dL (11.1 mmol/L);

random PG >200 mg/dL (11.1 mmol/L) in the presence of symptoms.

Any one of these criteria must be repeated on subsequent testing.

The FPG and 2-h PG are used to diagnose IFG and IGT, respectively.

There is currently no consensus on using one over the other.

While the 2-h PG is a more sensitive test in most populations [26],

the FPG is more convenient and reproducible, and less expensive.

A1C is not yet recommended for diagnosis (although it may be later

when assays are standardized worldwide).

So maybe UP TO DATE is not so up to date or I missed something somewhere....

Pamela

> Diabetes Care - Meet Your Goals

>

> It is important to control your cardiovascular (CV) risk factors

> to prevent stroke, heart attack and " end organ damage. " CV

> risk factors include: (modifiable) high blood pressure, diabetes,

> smoking, obesity, sedentary and high stress lifestyle, and

> (unmodifiable) personal/family history. Keep your risk factors

> controlled, meet your goals and avoid lengthy doctor visits and

> hospitalizations. Diabetes is reversible for many people!

>

> Understand Your Lab Values:

>

> Diagnosing Diabetes:

> Diabetes Fasting Blood Glucose (FBG) = > 126 Pre-Diabetes = 100-125

> ______________________

> Self Monitoring Blood Glucose (SMBG): Check a few times a week to

> daily depending on your situation. With insulin you will need to check

> up to 3 x daily. Also check if you feel hypoglycemic.

> *ALWAYS Bring your home SMBG record to each visit*

> Goal FBG = 90-130 Goal 2 hrs after eating = < 180

> ______________________

> Glycosylated Hemoglobin (HgA1C): This test reflects your glucose

> control over the last 3-4 months by measuring the % of hemoglobin

> molecules in the red blood cells with glucose attached. Goal is < 7%

> which equals an average BG of 170. ______________________

>

> Nephropathy (Kidney Labs): If you have kidney damage then eating

> less protein and plant protein (<0.8g/kg) can help slow the

> progression. Medications called ACEI (ace inhibitors) and others

> may slow progression. If your GFR is < 30 you should be friends

> with a local nephrologist.

> Goals: Serum creatinine (<1.3)___________

> Microalbuminuria (< 30 mg)_________________

> Glomerular Filtration Rate (GFR) > 60. ____________________

>

> Lipids: Goal: Fasting Total Chol < 200____________

> HDL >40 for women, >50 for men____________

> LDL < 100_____________

> Triglycerides < 150 ___________

> Blood Pressure: Goal < 130/80 mmHg ________________

>

> Health Care Maintenance:

> complete physical pap mammogram dental exam

> vision/retinopathy exam

> neuropathy/foot exam blood pressure

> labs cholesterol prostate thyroid nephropathy labs HgA1C

>

> colonoscopy (more fun than it sounds)

> Immunizations LCPHD 682-4042 Tetanus, Tdap, Influenza yearly ,

> Pneumoccocal (at time of diagnosis and revaccinate once after

> 5 years if > 65 years old)

> Aspirin - 81 mg daily if > 30 years old

>

> Follow Up Appointment: _____________________ or please call

>

> ___ Uncontrolled Diabetes 1 wk 2 wk 3 wk 4 wk

> ___ Mostly Controlled Diabetes 2 mo 3 mo 4 mo

> ___ Well Controlled Diabetes 6 mo 12 mo

>

> Please ensure you have enough medications until your next visit

>

> Questions? Call Dr. Wible 345-2437

>

>

>

>

>

> ---------------------------------

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done faster.

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[Guest guest]

http://www.acofp.org/publications/archives/1006/1006_3.html http://care.diabetesjournals.org/cgi/content/full/28/suppl_1/s4#T2http://www.obesityscam.com/myth8.3.htm standards are changing. i've just heard at a conference that a fasting glucose of >=126 for diagnosis of prediabetes will be lowered to >110. i continue to aggressively counsel patients whose fasting glucose is >=100. the point is less the number than the tendency to develop a constellation of morbidity, ie, metabolic syndrome. LL roxywible wrote: Diabetic parameters are correct according to UP TO DATE:Normal FPG is <100 mg/dL (5.6 mmol/L).IFG is defined as FPG 100 to 125 mg/dL (5.6-6.9 mmol/L).IGT is defined as 2-h PG 140 mg/dL (7.8 mmol/L) and <200 mg/dL (11.1 mmol/L).The criteria for the diagnosis of diabetes are unchanged (FPG 126 mg/dL (6.9 mmol/L); 2-h PG 200 mg/dL (11.1 mmol/L); random PG >200 mg/dL (11.1 mmol/L) in the presence of symptoms. Any one of these criteria must be repeated on subsequent testing.The FPG and 2-h PG are used to diagnose IFG and IGT, respectively. There is currently no consensus on using one over the

other.While the 2-h PG is a more sensitive test in most populations [26], the FPG is more convenient and reproducible, and less expensive.A1C is not yet recommended for diagnosis (although it may be later when assays are standardized worldwide).So maybe UP TO DATE is not so up to date or I missed something somewhere....Pamela> Diabetes Care - Meet Your Goals> > It is important to control your cardiovascular (CV) risk factors > to prevent stroke, heart attack and "end organ damage." CV > risk factors include: (modifiable) high blood pressure, diabetes, > smoking, obesity, sedentary and high stress lifestyle, and > (unmodifiable) personal/family history. Keep your risk factors > controlled, meet your goals and avoid lengthy doctor visits and > hospitalizations.

Diabetes is reversible for many people!> > Understand Your Lab Values:> > Diagnosing Diabetes: > Diabetes Fasting Blood Glucose (FBG) = > 126 Pre-Diabetes = 100-125> ______________________> Self Monitoring Blood Glucose (SMBG): Check a few times a week to > daily depending on your situation. With insulin you will need to check > up to 3 x daily. Also check if you feel hypoglycemic. > *ALWAYS Bring your home SMBG record to each visit* > Goal FBG = 90-130 Goal 2 hrs after eating = < 180> ______________________> Glycosylated Hemoglobin (HgA1C): This test reflects your glucose > control over the last 3-4 months by measuring the % of hemoglobin > molecules in the red blood cells with glucose attached. Goal is < 7% > which equals an average BG of 170. ______________________> > Nephropathy (Kidney Labs): If you have

kidney damage then eating > less protein and plant protein (<0.8g/kg) can help slow the > progression. Medications called ACEI (ace inhibitors) and others > may slow progression. If your GFR is < 30 you should be friends > with a local nephrologist.> Goals: Serum creatinine (<1.3)___________ > Microalbuminuria (< 30 mg)_________________> Glomerular Filtration Rate (GFR) > 60. ____________________> > Lipids: Goal: Fasting Total Chol < 200____________> HDL >40 for women, >50 for men____________ > LDL < 100_____________ > Triglycerides < 150 ___________> Blood Pressure: Goal < 130/80 mmHg ________________> > Health Care Maintenance: > complete physical pap mammogram dental exam > vision/retinopathy exam> neuropathy/foot exam blood pressure> labs cholesterol prostate thyroid

nephropathy labs HgA1C> > colonoscopy (more fun than it sounds) > Immunizations LCPHD 682-4042 Tetanus, Tdap, Influenza yearly , > Pneumoccocal (at time of diagnosis and revaccinate once after > 5 years if > 65 years old)> Aspirin - 81 mg daily if > 30 years old> > Follow Up Appointment: _____________________ or please call > > ___ Uncontrolled Diabetes 1 wk 2 wk 3 wk 4 wk> ___ Mostly Controlled Diabetes 2 mo 3 mo 4 mo > ___ Well Controlled Diabetes 6 mo 12 mo> > Please ensure you have enough medications until your next visit> > Questions? Call Dr. Wible 345-2437> > > > > > ---------------------------------> Check out the all-new Yahoo! Mail beta - Fire up a more powerful email and get things done faster. > > > > >

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[Guest guest]

Those all sound correct to me.

>

>

> Date: 2006/11/23 Thu PM 01:50:18 EST

> To:

> Subject: Re: Recheck diabetic parameters

>

> Diabetic parameters are correct according to UP TO DATE:

>

> Normal FPG is <100 mg/dL (5.6 mmol/L).

> IFG is defined as FPG 100 to 125 mg/dL (5.6-6.9 mmol/L).

> IGT is defined as 2-h PG 140 mg/dL (7.8 mmol/L) and

> <200 mg/dL (11.1 mmol/L).

> The criteria for the diagnosis of diabetes are unchanged

> (FPG 126 mg/dL (6.9 mmol/L); 2-h PG 200 mg/dL (11.1 mmol/L);

> random PG >200 mg/dL (11.1 mmol/L) in the presence of symptoms.

> Any one of these criteria must be repeated on subsequent testing.

> The FPG and 2-h PG are used to diagnose IFG and IGT, respectively.

> There is currently no consensus on using one over the other.

> While the 2-h PG is a more sensitive test in most populations [26],

> the FPG is more convenient and reproducible, and less expensive.

> A1C is not yet recommended for diagnosis (although it may be later

> when assays are standardized worldwide).

>

> So maybe UP TO DATE is not so up to date or I missed something somewhere....

>

>

> Pamela

>

>

>

>

> > Diabetes Care - Meet Your Goals

> >

> > It is important to control your cardiovascular (CV) risk factors

> > to prevent stroke, heart attack and " end organ damage. " CV

> > risk factors include: (modifiable) high blood pressure, diabetes,

> > smoking, obesity, sedentary and high stress lifestyle, and

> > (unmodifiable) personal/family history. Keep your risk factors

> > controlled, meet your goals and avoid lengthy doctor visits and

> > hospitalizations. Diabetes is reversible for many people!

> >

> > Understand Your Lab Values:

> >

> > Diagnosing Diabetes:

> > Diabetes Fasting Blood Glucose (FBG) = > 126 Pre-Diabetes = 100-125

> > ______________________

> > Self Monitoring Blood Glucose (SMBG): Check a few times a week to

> > daily depending on your situation. With insulin you will need to check

> > up to 3 x daily. Also check if you feel hypoglycemic.

> > *ALWAYS Bring your home SMBG record to each visit*

> > Goal FBG = 90-130 Goal 2 hrs after eating = < 180

> > ______________________

> > Glycosylated Hemoglobin (HgA1C): This test reflects your glucose

> > control over the last 3-4 months by measuring the % of hemoglobin

> > molecules in the red blood cells with glucose attached. Goal is < 7%

> > which equals an average BG of 170. ______________________

> >

> > Nephropathy (Kidney Labs): If you have kidney damage then eating

> > less protein and plant protein (<0.8g/kg) can help slow the

> > progression. Medications called ACEI (ace inhibitors) and others

> > may slow progression. If your GFR is < 30 you should be friends

> > with a local nephrologist.

> > Goals: Serum creatinine (<1.3)___________

> > Microalbuminuria (< 30 mg)_________________

> > Glomerular Filtration Rate (GFR) > 60. ____________________

> >

> > Lipids: Goal: Fasting Total Chol < 200____________

> > HDL >40 for women, >50 for men____________

> > LDL < 100_____________

> > Triglycerides < 150 ___________

> > Blood Pressure: Goal < 130/80 mmHg ________________

> >

> > Health Care Maintenance:

> > complete physical pap mammogram dental exam

> > vision/retinopathy exam

> > neuropathy/foot exam blood pressure

> > labs cholesterol prostate thyroid nephropathy labs HgA1C

> >

> > colonoscopy (more fun than it sounds)

> > Immunizations LCPHD 682-4042 Tetanus, Tdap, Influenza yearly ,

> > Pneumoccocal (at time of diagnosis and revaccinate once after

> > 5 years if > 65 years old)

> > Aspirin - 81 mg daily if > 30 years old

> >

> > Follow Up Appointment: _____________________ or please call

> >

> > ___ Uncontrolled Diabetes 1 wk 2 wk 3 wk 4 wk

> > ___ Mostly Controlled Diabetes 2 mo 3 mo 4 mo

> > ___ Well Controlled Diabetes 6 mo 12 mo

> >

> > Please ensure you have enough medications until your next visit

> >

> > Questions? Call Dr. Wible 345-2437

> >

> >

> >

> >

> >

> > ---------------------------------

> > Check out the all-new Yahoo! Mail beta - Fire up a more powerful email and

get things

> done faster.

> >

> >

> >

> >

> > ---------------------------------

> > Everyone is raving about the all-new Yahoo! Mail beta.

> >

>

>

>

>

>

[Guest guest]

fasting bg >126 is diabetes.

fasting bg >110 is part of " prediabetes " , igt, or metabolic syndrome...

and actually I think some groups (WHO?) are now saying fbg>105.

Tim

--

Malia, MD

Malia Family Medicine & Skin Sense Laser

6720 Pittsford-Palmyra Rd.

Perinton Square Mall

Fairport, NY 14450

(phone / fax)

www.relayhealth.com/doc/DrMalia

www.SkinSenseLaser.com

-- Confidentiality Notice --

This email message, including all the attachments, is for the sole use of

the intended recipient(s) and contains confidential information.

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> http://www.acofp.org/publications/archives/1006/1006_3.html

> http://care.diabetesjournals.org/cgi/content/full/28/suppl_1/s4#T2

> http://www.obesityscam.com/myth8.3.htm

> standards are changing.

> i've just heard at a conference that a fasting glucose of >=126 for

> diagnosis of prediabetes will be lowered to >110.

> i continue to aggressively counsel patients whose fasting glucose is

>>=100. the point is less the number than the tendency to develop a

> constellation of morbidity, ie, metabolic syndrome. LL

>

> roxywible wrote:

> Diabetic parameters are correct according to UP TO DATE:

>

> Normal FPG is <100 mg/dL (5.6 mmol/L).

> IFG is defined as FPG 100 to 125 mg/dL (5.6-6.9 mmol/L).

> IGT is defined as 2-h PG 140 mg/dL (7.8 mmol/L) and

> <200 mg/dL (11.1 mmol/L).

> The criteria for the diagnosis of diabetes are unchanged

> (FPG 126 mg/dL (6.9 mmol/L); 2-h PG 200 mg/dL (11.1 mmol/L);

> random PG >200 mg/dL (11.1 mmol/L) in the presence of symptoms.

> Any one of these criteria must be repeated on subsequent testing.

> The FPG and 2-h PG are used to diagnose IFG and IGT, respectively.

> There is currently no consensus on using one over the other.

> While the 2-h PG is a more sensitive test in most populations [26], the

> FPG is more convenient and reproducible, and less expensive.

> A1C is not yet recommended for diagnosis (although it may be later when

> assays are standardized worldwide).

>

> So maybe UP TO DATE is not so up to date or I missed something

> somewhere....

>

> Pamela

>

>

>> Diabetes Care - Meet Your Goals

>>

>> It is important to control your cardiovascular (CV) risk factors to

>> prevent stroke, heart attack and " end organ damage. " CV

>> risk factors include: (modifiable) high blood pressure, diabetes,

>> smoking, obesity, sedentary and high stress lifestyle, and

>> (unmodifiable) personal/family history. Keep your risk factors

>> controlled, meet your goals and avoid lengthy doctor visits and

>> hospitalizations. Diabetes is reversible for many people!

>>

>> Understand Your Lab Values:

>>

>> Diagnosing Diabetes:

>> Diabetes Fasting Blood Glucose (FBG) = > 126 Pre-Diabetes = 100-125

>> ______________________

>> Self Monitoring Blood Glucose (SMBG): Check a few times a week to

>> daily depending on your situation. With insulin you will need to check

>> up to 3 x daily. Also check if you feel hypoglycemic.

>> *ALWAYS Bring your home SMBG record to each visit*

>> Goal FBG = 90-130 Goal 2 hrs after eating = < 180

>> ______________________

>> Glycosylated Hemoglobin (HgA1C): This test reflects your glucose

>> control over the last 3-4 months by measuring the % of hemoglobin

>> molecules in the red blood cells with glucose attached. Goal is < 7%

>> which equals an average BG of 170. ______________________

>>

>> Nephropathy (Kidney Labs): If you have kidney damage then eating less

>> protein and plant protein (<0.8g/kg) can help slow the

>> progression. Medications called ACEI (ace inhibitors) and others may

>> slow progression. If your GFR is < 30 you should be friends with a

>> local nephrologist.

>> Goals: Serum creatinine (<1.3)___________

>> Microalbuminuria (< 30 mg)_________________

>> Glomerular Filtration Rate (GFR) > 60. ____________________

>>

>> Lipids: Goal: Fasting Total Chol < 200____________

>> HDL >40 for women, >50 for men____________

>> LDL < 100_____________

>> Triglycerides < 150 ___________

>> Blood Pressure: Goal < 130/80 mmHg ________________

>>

>> Health Care Maintenance:

>> complete physical pap mammogram dental exam

>> vision/retinopathy exam

>> neuropathy/foot exam blood pressure

>> labs cholesterol prostate thyroid nephropathy labs HgA1C

>>

>> colonoscopy (more fun than it sounds)

>> Immunizations LCPHD 682-4042 Tetanus, Tdap, Influenza yearly ,

>> Pneumoccocal (at time of diagnosis and revaccinate once after

>> 5 years if > 65 years old)

>> Aspirin - 81 mg daily if > 30 years old

>>

>> Follow Up Appointment: _____________________ or please call

>>

>> ___ Uncontrolled Diabetes 1 wk 2 wk 3 wk 4 wk

>> ___ Mostly Controlled Diabetes 2 mo 3 mo 4 mo

>> ___ Well Controlled Diabetes 6 mo 12 mo

>>

>> Please ensure you have enough medications until your next visit

>>

>> Questions? Call Dr. Wible 345-2437

>>

>>

>>

>>

>>

>> ---------------------------------

>> Check out the all-new Yahoo! Mail beta - Fire up a more powerful email

>> and get things

> done faster.

>>

>>

>>

>>

>> ---------------------------------

>> Everyone is raving about the all-new Yahoo! Mail beta.

>>

>

>

>

>

>

>

> ---------------------------------

> Cheap Talk? Check out Yahoo! Messenger's low PC-to-Phone call rates.

[Guest guest]

pardon, yes, >=126 fbg is currently diabetes, and yes, i believe it is WHO which is lowering the IFG #, which will dramatically increase the #'s with DM, because once the IFG # is lowered, the # at which DM is diagnosed will also decrease. LL" Malia, MD" wrote: fasting bg >126 is diabetes.fasting bg >110 is part of "prediabetes", igt, or metabolic syndrome...and actually I think some groups (WHO?) are now saying fbg>105.Tim-- Malia,

MDMalia Family Medicine & Skin Sense Laser6720 Pittsford-Palmyra Rd.Perinton Square MallFairport, NY 14450 (phone / fax)www.relayhealth.com/doc/DrMaliawww.SkinSenseLaser.com-- Confidentiality Notice --This email message, including all the attachments, is for the sole use ofthe intended recipient(s) and contains confidential information.Unauthorized use or disclosure is prohibited. If you are not the intendedrecipient, you may not use, disclose, copy or disseminate thisinformation. If you are not the intended recipient, please contact thesender immediately by reply email and destroy all copies of the originalmessage, including attachments.> http://www.acofp.org/publications/archives/1006/1006_3.html> http://care.diabetesjournals.org/cgi/content/full/28/suppl_1/s4#T2> http://www.obesityscam.com/myth8.3.htm> standards are changing.> i've just heard at a conference that a fasting glucose of >=126 for> diagnosis of prediabetes will be lowered to >110.> i continue to aggressively counsel patients whose fasting glucose is>>=100. the point is less the number than the tendency to develop a> constellation of morbidity, ie, metabolic syndrome. LL>> roxywible <roxywiblecomcast (DOT) net> wrote:> Diabetic parameters are correct according to UP TO DATE:>> Normal FPG is <100 mg/dL (5.6 mmol/L).> IFG is defined as FPG 100 to 125 mg/dL (5.6-6.9 mmol/L).> IGT is

defined as 2-h PG 140 mg/dL (7.8 mmol/L) and> <200 mg/dL (11.1 mmol/L).> The criteria for the diagnosis of diabetes are unchanged> (FPG 126 mg/dL (6.9 mmol/L); 2-h PG 200 mg/dL (11.1 mmol/L);> random PG >200 mg/dL (11.1 mmol/L) in the presence of symptoms.> Any one of these criteria must be repeated on subsequent testing.> The FPG and 2-h PG are used to diagnose IFG and IGT, respectively.> There is currently no consensus on using one over the other.> While the 2-h PG is a more sensitive test in most populations [26], the> FPG is more convenient and reproducible, and less expensive.> A1C is not yet recommended for diagnosis (although it may be later when> assays are standardized worldwide).>> So maybe UP TO DATE is not so up to date or I missed something> somewhere....>> Pamela>> >> Diabetes Care - Meet Your Goals>>>> It is important to control your cardiovascular (CV) risk factors to>> prevent stroke, heart attack and "end organ damage." CV>> risk factors include: (modifiable) high blood pressure, diabetes,>> smoking, obesity, sedentary and high stress lifestyle, and>> (unmodifiable) personal/family history. Keep your risk factors>> controlled, meet your goals and avoid lengthy doctor visits and>> hospitalizations. Diabetes is reversible for many people!>>>> Understand Your Lab Values:>>>> Diagnosing Diabetes:>> Diabetes Fasting Blood Glucose (FBG) = > 126 Pre-Diabetes = 100-125>>

______________________>> Self Monitoring Blood Glucose (SMBG): Check a few times a week to>> daily depending on your situation. With insulin you will need to check>> up to 3 x daily. Also check if you feel hypoglycemic.>> *ALWAYS Bring your home SMBG record to each visit*>> Goal FBG = 90-130 Goal 2 hrs after eating = < 180>> ______________________>> Glycosylated Hemoglobin (HgA1C): This test reflects your glucose>> control over the last 3-4 months by measuring the % of hemoglobin>> molecules in the red blood cells with glucose attached. Goal is < 7%>> which equals an average BG of 170. ______________________>>>> Nephropathy (Kidney Labs): If you have kidney damage then eating less>> protein and plant protein (<0.8g/kg) can help slow the>> progression. Medications called ACEI (ace inhibitors) and

others may>> slow progression. If your GFR is < 30 you should be friends with a>> local nephrologist.>> Goals: Serum creatinine (<1.3)___________>> Microalbuminuria (< 30 mg)_________________>> Glomerular Filtration Rate (GFR) > 60. ____________________>>>> Lipids: Goal: Fasting Total Chol < 200____________>> HDL >40 for women, >50 for men____________>> LDL < 100_____________>> Triglycerides < 150 ___________>> Blood Pressure: Goal < 130/80 mmHg ________________>>>> Health Care Maintenance:>> complete physical pap mammogram dental exam>> vision/retinopathy exam>> neuropathy/foot exam blood pressure>> labs cholesterol prostate thyroid nephropathy labs HgA1C>>>> colonoscopy (more fun than it sounds)>> Immunizations

LCPHD 682-4042 Tetanus, Tdap, Influenza yearly ,>> Pneumoccocal (at time of diagnosis and revaccinate once after>> 5 years if > 65 years old)>> Aspirin - 81 mg daily if > 30 years old>>>> Follow Up Appointment: _____________________ or please call>>>> ___ Uncontrolled Diabetes 1 wk 2 wk 3 wk 4 wk>> ___ Mostly Controlled Diabetes 2 mo 3 mo 4 mo>> ___ Well Controlled Diabetes 6 mo 12 mo>>>> Please ensure you have enough medications until your next visit>>>> Questions? Call Dr. Wible 345-2437>>>>>>>>>>>> --------------------------------->> Check out the all-new Yahoo! Mail beta - Fire up a more powerful email>> and get things> done faster.>>>>>>>>>>

--------------------------------->> Everyone is raving about the all-new Yahoo! Mail beta.>>>>>>>>> ---------------------------------> Cheap Talk? Check out Yahoo! Messenger's low PC-to-Phone call rates.

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[Guest guest]

;-) ... great issue to discuss on Thanksgiving!

I wonder what the national average fasting BG was this morning after the

all that food yesterday.

Anyone else have a late evening " sliver " of pumpkin pie... and sweet

potato pie... or am I the only one?

Tim

--

Malia, MD

Malia Family Medicine & Skin Sense Laser

6720 Pittsford-Palmyra Rd.

Perinton Square Mall

Fairport, NY 14450

(phone / fax)

www.relayhealth.com/doc/DrMalia

www.SkinSenseLaser.com

-- Confidentiality Notice --

This email message, including all the attachments, is for the sole use of

the intended recipient(s) and contains confidential information.

Unauthorized use or disclosure is prohibited. If you are not the intended

recipient, you may not use, disclose, copy or disseminate this

information. If you are not the intended recipient, please contact the

sender immediately by reply email and destroy all copies of the original

message, including attachments.

> pardon, yes, >=126 fbg is currently diabetes, and yes, i believe it is

> WHO which is lowering the IFG #, which will dramatically increase the

> #'s with DM, because once the IFG # is lowered, the # at which DM is

> diagnosed will also decrease.

> LL

>

> " Malia, MD " wrote:

> fasting bg >126 is diabetes.

> fasting bg >110 is part of " prediabetes " , igt, or metabolic syndrome...

> and actually I think some groups (WHO?) are now saying fbg>105.

> Tim

>

> --

> Malia, MD

>

> Malia Family Medicine & Skin Sense Laser

> 6720 Pittsford-Palmyra Rd.

> Perinton Square Mall

> Fairport, NY 14450

>

> (phone / fax)

> www.relayhealth.com/doc/DrMalia

> www.SkinSenseLaser.com

>

> -- Confidentiality Notice --

> This email message, including all the attachments, is for the sole use

> of the intended recipient(s) and contains confidential information.

> Unauthorized use or disclosure is prohibited. If you are not the

> intended recipient, you may not use, disclose, copy or disseminate this

> information. If you are not the intended recipient, please contact the

> sender immediately by reply email and destroy all copies of the original

> message, including attachments.

>

>> http://www.acofp.org/publications/archives/1006/1006_3.html

>> http://care.diabetesjournals.org/cgi/content/full/28/suppl_1/s4#T2

>> http://www.obesityscam.com/myth8.3.htm

>> standards are changing.

>> i've just heard at a conference that a fasting glucose of >=126 for

>> diagnosis of prediabetes will be lowered to >110.

>> i continue to aggressively counsel patients whose fasting glucose is

>>>=100. the point is less the number than the tendency to develop a

>> constellation of morbidity, ie, metabolic syndrome. LL

>>

>> roxywible wrote:

>> Diabetic parameters are correct according to UP TO DATE:

>>

>> Normal FPG is <100 mg/dL (5.6 mmol/L).

>> IFG is defined as FPG 100 to 125 mg/dL (5.6-6.9 mmol/L).

>> IGT is defined as 2-h PG 140 mg/dL (7.8 mmol/L) and

>> <200 mg/dL (11.1 mmol/L).

>> The criteria for the diagnosis of diabetes are unchanged

>> (FPG 126 mg/dL (6.9 mmol/L); 2-h PG 200 mg/dL (11.1 mmol/L);

>> random PG >200 mg/dL (11.1 mmol/L) in the presence of symptoms.

>> Any one of these criteria must be repeated on subsequent testing. The

>> FPG and 2-h PG are used to diagnose IFG and IGT, respectively. There

>> is currently no consensus on using one over the other.

>> While the 2-h PG is a more sensitive test in most populations [26],

>> the FPG is more convenient and reproducible, and less expensive.

>> A1C is not yet recommended for diagnosis (although it may be later

>> when assays are standardized worldwide).

>>

>> So maybe UP TO DATE is not so up to date or I missed something

>> somewhere....

>>

>> Pamela

>>

>>

>>> Diabetes Care - Meet Your Goals

>>>

>>> It is important to control your cardiovascular (CV) risk factors to

>>> prevent stroke, heart attack and " end organ damage. " CV

>>> risk factors include: (modifiable) high blood pressure, diabetes,

>>> smoking, obesity, sedentary and high stress lifestyle, and

>>> (unmodifiable) personal/family history. Keep your risk factors

>>> controlled, meet your goals and avoid lengthy doctor visits and

>>> hospitalizations. Diabetes is reversible for many people!

>>>

>>> Understand Your Lab Values:

>>>

>>> Diagnosing Diabetes:

>>> Diabetes Fasting Blood Glucose (FBG) = > 126 Pre-Diabetes = 100-125

>>> ______________________

>>> Self Monitoring Blood Glucose (SMBG): Check a few times a week to

>>> daily depending on your situation. With insulin you will need to

>>> check up to 3 x daily. Also check if you feel hypoglycemic.

>>> *ALWAYS Bring your home SMBG record to each visit*

>>> Goal FBG = 90-130 Goal 2 hrs after eating = < 180

>>> ______________________

>>> Glycosylated Hemoglobin (HgA1C): This test reflects your glucose

>>> control over the last 3-4 months by measuring the % of hemoglobin

>>> molecules in the red blood cells with glucose attached. Goal is < 7%

>>> which equals an average BG of 170. ______________________

>>>

>>> Nephropathy (Kidney Labs): If you have kidney damage then eating less

>>> protein and plant protein (<0.8g/kg) can help slow the

>>> progression. Medications called ACEI (ace inhibitors) and others may

>>> slow progression. If your GFR is < 30 you should be friends with a

>>> local nephrologist.

>>> Goals: Serum creatinine (<1.3)___________

>>> Microalbuminuria (< 30 mg)_________________

>>> Glomerular Filtration Rate (GFR) > 60. ____________________

>>>

>>> Lipids: Goal: Fasting Total Chol < 200____________

>>> HDL >40 for women, >50 for men____________

>>> LDL < 100_____________

>>> Triglycerides < 150 ___________

>>> Blood Pressure: Goal < 130/80 mmHg ________________

>>>

>>> Health Care Maintenance:

>>> complete physical pap mammogram dental exam

>>> vision/retinopathy exam

>>> neuropathy/foot exam blood pressure

>>> labs cholesterol prostate thyroid nephropathy labs HgA1C

>>>

>>> colonoscopy (more fun than it sounds)

>>> Immunizations LCPHD 682-4042 Tetanus, Tdap, Influenza yearly ,

>>> Pneumoccocal (at time of diagnosis and revaccinate once after

>>> 5 years if > 65 years old)

>>> Aspirin - 81 mg daily if > 30 years old

>>>

>>> Follow Up Appointment: _____________________ or please call

>>>

>>> ___ Uncontrolled Diabetes 1 wk 2 wk 3 wk 4 wk

>>> ___ Mostly Controlled Diabetes 2 mo 3 mo 4 mo

>>> ___ Well Controlled Diabetes 6 mo 12 mo

>>>

>>> Please ensure you have enough medications until your next visit

>>>

>>> Questions? Call Dr. Wible 345-2437

>>>

>>>

>>>

>>>

>>>

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