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Download organ protection - M.V Hospital for Diabetes
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ORGAN PROTECTION INTERVENTIONS FOR MACROVASCULAR RISK REDUCTION Risk Factor Goal Smoking Cessation, using counseling or medications Obesity Weight Reduction by: Exercise: 30 – 60 minutes of moderate intensity aerobic exercise at least 3 times per week Diet: Fat of <30% total calories with <7% saturated fat and <1% trans fat; sodium restriction Hypertension Blood Pressure of <130/80mmHg Dyslipidemia TG <150mg/dL High Risk Patients: LDL <70mg/dL Non-HDL <100mg/dL Apo B <80mg/dL Non-High Risk Patients: LDL <100mg/dL Non-HDL <130mg/dL Apo B <90mg/dL INTERVENTIONS FOR MACROVASCULAR RISK REDUCTION-CONTD Hyperglycemia HbA1C <7% Hypercoagulability/Dysfibrinolysis Aspirin primary prevention in high risk patients* Secondary prevention in patients with cardiovascular disease Inflammation High-sensitivity C-reactive protein <2mg/L** PROTECTION OF KIDNEYS Complication Method Frequency Optimal Goals Nephropathy Urine Microalbumin Annually* Albumin <30mg/24hr or Albumin- Creatinine ratio<30mg/g in random urine specimen GFR estimation by serum creatinine Annually GFR > 90 mL/min/1.72m2 DIABETIC RETINOPATHY Diabetic retinopathy is a complication from diabetes that affects the eyes. It sometimes leads to partial vision loss and eventually results in blindness. The leading cause of blindness in adults, diabetic retinopathy is caused by damage to or swelling of the blood vessels in the back of the eye (the retina), which is constructed of light-sensitive tissue. In some cases, blood vessels can leak fluid into the eye's macula causing blurred vision. In other cases, new blood vessels grow abnormally, attaching to the surface of the retina. Anyone with type 1 or type 2 diabetes is at risk but especially longtime diabetics and those with less controlled blood sugar levels. PROTECTION FOR EYES Complication Method Retinopathy Regular eye check ups Dilated and comprehensive eye exam Frequency Optimal Goals Initially Type 1: 3–5 years after onset Type 2: From diagnosis Annually; more frequently if pregnant or progressive retinopathy Primary prevention, delay of progression and prevention of blindness from retinopathy NEUROPATHY Complication Method Frequency Optimal Goals Neuropathy Daily self-inspection of feet Every visit Intact skin Comprehensive foot examination Annually Normal examination Examination for distal symmetric polyneuropathy At diagnosis and annually Early detection and limb preservation Assessment for autonomic neuropathy Type 1: 5 years after diagnosis Type 2: from diagnosis Early detection, symptom control, recognition of associated cardiovascular risk
