Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content +++ DIABETES MELLITUS (DM), TYPE 2 +++ Population ++ –Adults. +++ Recommendation ++ USPSTF 2015 ++ –Screen as part of cardiovascular risk assessment if age 40–70 y and BMI >25. ++ Source ++ –USPSTF. Abnormal Blood Glucose and Type 2 Diabetes Mellitus: Screening. 2015. +++ Comment ++ Screen at least every 3 y in asymptomatic adults. +++ OBESITY +++ Population ++ –Adults age >18 y. +++ Recommendation ++ AAFP 2012, USPSTF 2012 ++ –Screen all adults and offer intensive counseling and behavioral interventions to promote sustained weight loss in obese adults with BMI ≥30 kg/m2. ++ Source ++ –USPSTF. Obesity in Adults: Screening and Management. 2012. +++ Comment ++ Intensive counseling involves more than one session per month for at least 3 mo. +++ Recommendations ++ VA/DoD 2014 ++ –Measure height, weight, and BMI at least annually. –Consider annual measurement of waist circumference. ++ Source ++ –VA/DoD Clinical Practice Guideline for Screening and Management of Overweight and Obesity, Version 2.0. 2014. +++ Comment ++ Offer intensive intervention to promote weight loss to Obese adults (BMI ≥30 or waist circumference ≥40 in. [men] or ≥35 in. [women]). Overweight adults (BMI 25–29.9) with an obesity-associated condition.a + ++ aHTN, DM type 2, dyslipidemia, obstructive sleep apnea, degenerative joint disease, or metabolic syndrome. +++ THYROID CANCER +++ Population ++ –Asymptomatic persons. +++ Recommendations ++ USPSTF 2017 ++ –Do not screen asymptomatic people with ultrasound. –Be aware of higher-risk patients: radiation administered in infancy and childhood for benign conditions (thymus enlargement, acne), which results in an increased risk beginning 5 y after radiation and continuing until >20 y later; nuclear fallout exposure; history of goiter; family history of thyroid disease; female gender; Asian race. (Int J Cancer. 2001;93:745) (N Engl J Med. 2015;373:2347) (N Engl J Med. 2012; 367:705) ++ Sources ++ –JAMA. 2017;317(18):1882-1887. –http://www.aafp.org/online/en/home/clinical/exam.html –http://www.cancer.org +++ Comments ++ Neck palpation for nodules in asymptomatic individuals has sensitivity of 15%–38% and specificity of 93%–100%. Only a small proportion of nodular thyroid glands are neoplastic, resulting in a high false-positive rate. Fine-needle aspiration (FNA) is the procedure of choice for evaluation of thyroid nodules. (Otolaryngol Clin North Am. 2010;43:229-238) +++ THYROID DYSFUNCTION +++ Population ++ –Adults. +++ Recommendations ++ AAFP ... GET ACCESS TO THIS RESOURCE Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessPharmacy 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessPharmacy Full Site: One-Year Individual Subscription $595 USD Buy Now View All Subscription Options