The major risk factors for type 2 diabetes mellitus are the following:
• Age greater than 45 years (though type 2 diabetes mellitus is occurring with increasing frequency in young individuals)
• Weight greater than 120% of desirable body weight
• Family history of type 2 diabetes in a first- degree relative (eg, parent or sibling)
• Hispanic, Native American, African American, Asian American, or Pacific Islander descent
• History of previous impaired glucose tolerance or impaired fasting glucose
• Hypertension (>140/90 mm Hg) or dyslipidemia (high-density lipoprotein cholesterol level <40 mg/dL or triglyceride level >150 mg/dL)
• History of gestational diabetes mellitus or of delivering a baby with a birth weight of over 9 lb
• Polycystic ovarian syndrome (which results in insulin resistance)
I do include elevated lead levels because lead is associated with Type II diabetes . When you remove the lead, blood sugar levels become stabilized. Test your heavy metal status. Schedule your environmental exposure consult this week.
Some studies suggest that environmental pollutants may play a role in the development and progression of type 2 diabetes mellitus.
Which of the following fasting blood glucose levels signifies prediabetes?
Prediabetes often precedes overt type 2 diabetes. Prediabetes is defined by a fasting blood glucose level of 100-125 mg/dL or a 2-hour post-oral glucose tolerance test glucose level of 140-200 mg/dL. Persons with prediabetes are at increased risk for macrovascular disease as well as diabetes.
Which of the following tests is the criterion standard for monitoring long-term glycemic control?
Binding of glucose to hemoglobin A is a nonenzymatic process that occurs over the lifespan of a red blood cell, which averages 120 days. Measurement of A1c thus reflects plasma glucose levels over the preceding 2-3 months. I test every patient for HgA1c levels.
Which of the following is the most common complication in patients with type 2 diabetes?
Peripheral neuropathy is the most common complication observed in patients with type 2 diabetes in outpatient clinics. Patients may have paresthesias, numbness, or pain. The feet are involved more often than the hands. We offer ozone chelation, prolozone injections and oral protocols to treat peripheral neuropathy.
Improved glycemic control early may alleviate some of the symptoms, although sometimes symptoms actually worsen with lowering of blood glucose levels. Later symptomatic therapy largely is empirical and may include the following:
• Low-dose tricyclic antidepressants
• Duloxetine
• Anticonvulsants (eg, phenytoin, gabapentin, carbamazepine)
• Topical capsaicin
• Various pain medications, including nonsteroidal anti-inflammatory drugs
Which of the following is considered a first-line treatment for type 2 diabetes mellitus?
Metformin is the standard first line treatment for Type II diabetes.
Second Nature Care
I recommend Xymogen's CinnDromX and Berbemycin to stabilize blood sugar levels. These products are more effective than Metformin in double-blind studies.
Most of my patients are no longer taking insulin or diabetes pharmaceuticals.
They have changed their diet, exercise daily and follow their nutraceutical regimen of taking critical nutrients that their bodies need.
Original quiz in Medscape Jan. 2015
