Staged Diabetes Management: Complications of Diabetes and Metabolic Syndrome International Diabetes Center 2004 Priorities of Care for Adults with Diabetes Prevention - Diagnosis Preventions Prediabetes (IFG -IGT) & Metabolic Syndrome Preventions Prediabetes (IFG -IGT) & Metabolic Syndrome Diagnosis Fasting glucose > 126 mg/dL (7 mmol/L) or Diagnosis Fasting glucose > 126 mg/dL (7 mmol/L) or Casual glucose > 200 mg/mL (11.1 mmol/L) + Symptoms Casual glucose > 200 mg/mL (11.1 mmol/L) + Symptoms History and Physical Exam History and Physical Exam Diabetes Self-Management Skills Lifestyle Patient Education BG Monitoring Medical Nutrition Physical Activity Glucose Insulin Resistance HbA1c < 7.0% HbA1c < 7.0% SMBG (~ 50% of readings) SMBG (~ 50% of readings) Pre Meal 70-140 mg/dL Pre Meal 70-140 mg/dL (3.8 mmol/L- 7.8 mmol/L) (3.8 mmol/L- 7.8 mmol/L) Post Meal 40 mg/dL (1.0 mmol/L) (1.0 mmol/L) Statin therapy Statin therapy Fibrate therapy Fibrate therapy Combination therapy Combination therapy Microvascular Complications Other Essential Areas of Care Hypertension Blood Pressure Blood Pressure Targets Targets Mean BP 126 mg/dL (7 mmol/L) or Casual glucose > 200 mg/mL (11.1 mmol/L) + Symptoms Casual glucose > 200 mg/mL (11.1 mmol/L) + Symptoms History and Physical Exam History and Physical Exam Diabetes Self-Management Skills Lifestyle Patient Education BG Monitoring Medical Nutrition Physical Activity Glucose Insulin Resistance HbA1c < 7.0% HbA1c < 7.0% SMBG (~ 50% of readings) SMBG (~ 50% of readings) Pre Meal 70-140 mg/dL Pre Meal 70-140 mg/dL (3.8 mmol/L-7.8 mmol/L) (3.8 mmol/L-7.8 mmol/L) Post Meal 40 mg/dL (1.0 mmol/L) (1.0 mmol/L) Statin therapy Statin therapy Fibrate therapy Fibrate therapy Combination therapy Combination therapy Microvascular Complications Other Essential Areas of Care Hypertension Blood Pressure Blood Pressure Targets Targets Mean BP 126 mg/dL (7 mmol/L) or Diagnosis Fasting glucose > 126 mg/dL (7 mmol/L) or Casual glucose > 200 mg/mL (11.1 mmol/L) + Symptoms Casual glucose > 200 mg/mL (11.1 mmol/L) + Symptoms History and Physical Exam History and Physical Exam Diabetes Self-Management Skills Lifestyle Patient Education BG Monitoring Medical Nutrition Physical Activity Glucose Insulin Resistance HbA1c < 7.0% HbA1c < 7.0% SMBG (~ 50% of readings) SMBG (~ 50% of readings) Pre Meal 70-140 mg/dL Pre Meal 70-140 mg/dL (3.8 mmol/L-7.8 mmol/L) (3.8 mmol/L-7.8 mmol/L) Post Meal 40 mg/dL (1.0 mmol/L) (1.0 mmol/L) Statin therapy Statin therapy Fibrate therapy Fibrate therapy Combination therapy Combination therapy Microvascular Complications Other Essential Areas of Care Hypertension Blood Pressure Blood Pressure Targets Targets Mean BP