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
