screening and eligibility for dpp clinical guidelines
Post on 15-Jan-2016
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Screening and Eligibility for DPPScreening and Eligibility for DPPClinical GuidelinesClinical Guidelines
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EligibilityEligibility
• Impaired Fasting Glucose (IFG) = Impaired Glucose Tolerance (IGT)= Prediabetes
• Individuals eligible for SCREENING – follow Core Element guidelines
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At Risk for DiabetesAt Risk for Diabetes
• Family member with type 2 diabetes (parents or siblings with diabetes)
• Overweight– BMI ≥25 kg/m2
• Age ≥ 35• Habitual inactivity (no regular physical activity, less than 30
minutes 3 times a week)• Previous diagnosis of Prediabetes (IFG or IGT)• Prior GDM or delivery of a baby weighing > 9 lbs• History of Polycystic Ovarian Syndrome• Any other component of Metabolic Syndrome (ATP III)
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ScreeningScreening
• Remember – there will be many more individuals who are eligible for screening than are eligible for participation
• Exclude eligible individuals from participation in this project who have any of the exclusion diagnoses/conditions:
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Exclusion CriteriaExclusion Criteria
– Current diagnosis of pregnancy (reconsider participation 6 weeks after delivery, suspend participation if becomes pregnant during project)
– Active alcohol or substance abuse by provider judgment that would affect successful participation
– End Stage Renal Disease on dialysis– Previous diagnosis of diabetes (not eligible for
diabetes prevention)– Current diagnosis of cancer undergoing treatment that
prohibits participation – provider judgment
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Community ScreeningCommunity Screening
Do Random Blood Sugar (RBS) AND ADA Risk Test
• (+) Screening = RBS > 100 OR ADA Score ≥ 10 = Refer to Clinic/schedule for OGTT if agrees to participate
• (–) Screening = Provide education/information and offer f/u
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Clinic ScreeningClinic Screening
2 hour OGTT AND ADA Risk Test (if not already done)
• Do not use Fasting Blood Sugar (FBS) testing in place of 2 hr OGTT
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2 hour OGTT2 hour OGTT
• Only 1 OGTT result necessary for diagnosis of Prediabetes
• If individual has a previous diagnosis of Prediabetes AND:
1. OGTT done < 6 months before baseline assessment = do a FBS to ensure not progressed to Diabetes
2. OGTT done > 6 months before baseline assessment = REPEAT 2 hour OGTT
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2 hour OGTT results2 hour OGTT results
NORMAL PRE-DM DIABETES
(presume)
FBS < 100 100 – 125 125
2 hr BS < 140 140 – 199 200
• One or more abnormal result in the Pre-diabetes range = Pre-diabetes
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Diagnosing Pre-diabetesDiagnosing Pre-diabetes
• Diagnosis must be made by a Licensed Independent Practitioner
• Notification of individual can be delegated to a clinical staff/project staff member – RN, RD, etc.
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