Diabetes Mellitus

Question 1

What are the 4 tests to diagnosis diabetes?

Answer 1

1. fasting blood sugar >126
2. random blood glucose >200 AND symptoms
3. blood sugar >200 after oral glucose tolerance test
4. hemoglobin A1C >6.5%

Question 2

What is the bimodal peak for Type 1 diabetes?

Answer 2

4-6 years old and 10-14 years old

Question 3

What causes Type 1 DM

Answer 3

autoimmune destruction of pancreatic beta cells

Question 4

What do kids with Type 1 DM usually present with?

Answer 4

DKA

Question 5

Lab diagnositics of DKA

Answer 5

BG >250, bicarb

Question 6

What are two buzz words for DKA?

Answer 6

fruity breath, kussmaul respirations

Question 7

Management of DKA

Answer 7

fluids, electrolytes, insulin and look for precipitating events

Question 8

Why do you need to check the patient’s potassium before giving insulin?

Answer 8

insulin can make potassium level go down

Question 9

When do you switch from NS to D 5 1/2 NS when treating DKA?

Answer 9

when sugar gets below 250

Question 10

What electrolyte is typically falsely lowered in DKA?

Answer 10

sodium–it will correct with NS, usually no need to add extra

Question 11

What is the purpose of giving insulin in DKA when the fluids should bring the sugar down anyway?

Answer 11

to stop ketogenesis which will stop the acidosis

Question 12

What is a serious complication to watch for when correcting DKA?

Answer 12

cerebral edema

Question 13

What are two medications that can cause glucose to rise?

Answer 13

glucocorticoids and some antihypertensives

Question 14

What is the most common short acting insulin and when do you take it?

Answer 14

humalog–with meals

Question 15

What is the long acting insulin without a peak or trough?

Answer 15

lantis–lasts 24 hours

Question 16

How do sulfonylureas work and what are 2 names?

Answer 16

stimulate pancreas to make more insulin–Glipizide and Glyburide–CAN CAUSE HYPOGLYCEMIA

Question 17

How do Biguanides work and what is the name?

Answer 17

suppress hepatic gluconeogenesis–Metformin–NO hypoglycemia but can cause lactic acidosis (ex: when pt gets contrast for a CT scan)

Question 18

What is the most common SE from metformin?

Answer 18

GI symptoms (diarrhea, abd pain–should go away with time)

Question 19

How do Thiazolidenediones (TZDs) work and what are the names?

Answer 19

increase insulin sensitivity and increase fat metabolism–Actos and Avandia

Question 20

What are two SE of TZDs and what needs to be checked periodically when pts are on these?

Answer 20

hepatitis and edema–check LFTs

Question 21

What can patients do at home to treat hypoglycemia?

Answer 21

candy/juice or IM glucagon

Question 22

What IV fluid can you give for hypoglycemia?

Answer 22

D50 ampule