Diabetes Mellitus Flashcards
What are the 4 tests to diagnosis diabetes?
- fasting blood sugar >126
- random blood glucose >200 AND symptoms
- blood sugar >200 after oral glucose tolerance test
- hemoglobin A1C >6.5%
What is the bimodal peak for Type 1 diabetes?
4-6 years old and 10-14 years old
What causes Type 1 DM
autoimmune destruction of pancreatic beta cells
What do kids with Type 1 DM usually present with?
DKA
Lab diagnositics of DKA
BG >250, bicarb
What are two buzz words for DKA?
fruity breath, kussmaul respirations
Management of DKA
fluids, electrolytes, insulin and look for precipitating events
Why do you need to check the patient’s potassium before giving insulin?
insulin can make potassium level go down
When do you switch from NS to D 5 1/2 NS when treating DKA?
when sugar gets below 250
What electrolyte is typically falsely lowered in DKA?
sodium–it will correct with NS, usually no need to add extra
What is the purpose of giving insulin in DKA when the fluids should bring the sugar down anyway?
to stop ketogenesis which will stop the acidosis
What is a serious complication to watch for when correcting DKA?
cerebral edema
What are two medications that can cause glucose to rise?
glucocorticoids and some antihypertensives
What is the most common short acting insulin and when do you take it?
humalog–with meals
What is the long acting insulin without a peak or trough?
lantis–lasts 24 hours
How do sulfonylureas work and what are 2 names?
stimulate pancreas to make more insulin–Glipizide and Glyburide–CAN CAUSE HYPOGLYCEMIA
How do Biguanides work and what is the name?
suppress hepatic gluconeogenesis–Metformin–NO hypoglycemia but can cause lactic acidosis (ex: when pt gets contrast for a CT scan)
What is the most common SE from metformin?
GI symptoms (diarrhea, abd pain–should go away with time)
How do Thiazolidenediones (TZDs) work and what are the names?
increase insulin sensitivity and increase fat metabolism–Actos and Avandia
What are two SE of TZDs and what needs to be checked periodically when pts are on these?
hepatitis and edema–check LFTs
What can patients do at home to treat hypoglycemia?
candy/juice or IM glucagon
What IV fluid can you give for hypoglycemia?
D50 ampule
