Diabetes and thyroid disease in pediatrics Flashcards
is type I diabetes more common in people under 40 or over? what about type II?
type I - most common under 40
type II - most common over 40
what are the diagnostic lab findings for diabetes?
- random glucose over 300 mg/dL
- fasting glucose over 200 mg/dL
which diabetes type tends toward ketosis?
type I
symptoms of diabetes
- polyuria
- polydipsia
- polyphagia
how much insulin is required in non-ketotic patients per day?
0.25 units/kg/day
what is the general insulin dosing regimen per day?
- 2/3 daily dose 30-60m before breakfast
- 1/3 daily dose 30-60m before dinner
what are the principles of diet treatment for diabetics?
- well balanced diet
- consistent day to day intake
- eat meals and snacks at same time every day
- consume snacks to prevent hypoglycemia
- avoid pure sugar foods
- reduce cholesterol, total fat, saturated fat
- maintain appropriate weight for height
- increase fiber intake
- avoid foods high in salt
- avoid excessive protein intake
what do stress hormones (cortisol) do to blood glucose?
raise
what is a good long term indicator of glucose control?
HbA1C
definition: DKA
- blood glucose over 200 mg/dL
- acidosis and or bicarbonate under 15 mEq/L
prolonged insulin deficiency leads to:
- hyperglycemia from increased gluconeogenesis
- increased gluconeogenesis and decreased glucose utilization
- increased lipolysis and conversion of free fatty acids to ketones leads to progressive ketoacidosis
treatment for DKA is based on what 4 principles?
- restoration of intravascular fluid volume
- inhibit lipolysis / return to glucose utilization
- replacement of body salts
- correction of acidosis
what are the specific treatment to deal with DKA?
- restoration of intravascular fluid volume - NS or LR
- inhibit lipolysis / return to glucose utilization - regular insulin IV
- replacement of body salts - 0.45 to 0.9 NS, potassium added to IVF
- correction of acidosis - usually resolves spontaneously with fluids
how are the fetal and maternal pituitary - thyroid axes related?
they are completely independent of each other
fetal thyroid development and TSH is found by what week?
14
which lab test is most commonly used to evaluate thyroid function?
TSH
what is T3 resin uptake?
- calculates free hormone index using radiolabeled T3 tracer and a resin that traps the unbound radiolabeled T3
- designed to distinguish TBG excess and deficiency from hypo or hyperthyroidism
signs and symptoms of hypothyroidism
- growth retardation
- decreased physical activity
- impaired tissue perfusion
- constipation
- thickened tongue
medications / treatment for hyperthyroidism
- propanolol
- PTU
- methimazole
- iodide
- radiation
- surgery
