Diabetes *** Flashcards
Med for wt loss
Semaglutide 2.4mg SC q1weekly,
RF for T1
fam hx
Sx
Polyuria, polydipsia, wt loss
Complications
Macrovascular (CVD, CVA, PAD), microvascular (retinopathy, nephropathy, neuropathy), infection, ED
Hypoglycemia Sx
palpitations, sweating, trembling, anxiety, hunger, N/V, drowsiness, vision change, HA
Hypoglycemia RF
prior episode, low a1c, hypoglycemia unawareness, CKD, preschool/ adolescent/ pregnancy/ elderly
Hypoglycemia Rx
15g carbs (¾ cup juice, 1 tbsp honey) - restest in 15 mins and repeat if BG <4
Severe: 1mg glucagon SC/ IM
Hyperglycemia Sx
Polyphagia, polydipsia, polyuria, blurred vision, fatigue, paresthesia, arrhythmia
DKA sx
Kussmaul’s breathing, confusion, dehydration, impaired cognition, abdo pain, N/V
DKA precipitating factors
Infection, illness, missed insulin, infarction, intoxication
Dx of T1
If asymptomatic, repeat test on another day
8hr FPG >7
Random BG >11.1
Hba1c >6.5
Factors that increase a1c
iron deficiency, low B12, alcoholism, chronic opioid use
Factors that decrease a1c
use of iron/ B12/ ASA/ vit C, hemaglobinopathy, chronic liver disease, RA
Targets for pre + postprandial glucose (+ if frail)
Preprandial 4-7
Postprandial 5-10
If frail/ dementia = preprandial 6-9 and postprandial <14
Ix for new dx DM
ECG if >40 y/o, DM >15 yrs, end ogan damage, CVD RF (HTN, smoking, CKD, obesity, ED)
Stress test if cardiac sx
Monitoring (q6mo + annual)
q6mo
BP <130/80
A1C <7% adults, <7.5% children
Annual
Fasting lipids
Optometry (5 yrs after dx)
Albumin/Cr ratio + Cr (5 yrs after dx)
Monofilament + foot exam (5 yrs after dx)
Screen for ED, depression, eating disorder, NAFLD
Driving safety
Measure BG before driving
Keep supply of carbs in car
Do not drive if BG <4
Report to licensing if on insulin and 1) any severe hypo while driving in past 12 months or 2) >1 severe hypo while awake but not driving in past 6 months