Diabetic complications parameters/management

Question 1

treatment of mild and moderate hypoglycaemia

Answer 1

• fast acting glucose15-20g drink wait 15 minutes
• test blood glucose if still <4 then repeat 3 times
• call dr and consider IV glucose 10% 100ml/hour
• then give 20g long acting carb

Question 2

treatment of severe hypoglycaemia

Answer 2

-ABCDE
-stop insulin
-contact Dr
-IV glucose 20% over 10-15 minutes
IM glucagon 1mcg
-re-check after 15 minutes
-long acting carbs 20g

Question 3

management of hypoglycaemia if on enteral feeding

Answer 3

50-70ml glucojuice, once glucose <4mmol restart feed

Question 4

DKA management 13

Answer 4

VIP

• hr1 volume: IV 1l 0.9% saline over 1hr
• hr1 insulin: 6 units IV
• hr2 potassium: KCL 1l nacl 0.9%, 500ml 2nd hr
• glucose: if<14mmol in 1st 4hrs give 10% glucose 500ml with 20mmol kcl at 100ml/hr
• ECG
• LMWH
• blood cultures
• central line
• chest xray
• urinary catheter
• record GCS score

Question 5

HHS diagnosis

Answer 5

hyperosmolality >320
hyperglycaemia >30
hypovolaemia

Question 6

hypoglycaemia dx

Answer 6

<4

Question 7

severe hypoglycaemia

Answer 7

requires assistance to treat

Question 8

DKA diagnosis

Answer 8

D: hyperglycaemia >11
K: ketones capillary/urine >3
A:acidosis pH <7.3 or bicarb <15

Question 9

HHS management 8

Answer 9

1. commence IV 0.9% nacl 1l over 1hr
2. commence insulin actrapid 0.05units/kg/hr IV only sig ketonaemia (start insulin at 6hr if glucose not falling or <14)
3. LMWH
4. Treat precipitant
5. catheterisation for fluid
6. culture and foot exam
7. potassium if 3.5-5.5 40mmol kcl iv
8. glucose if <14mmol

Question 10

HHS fluid aim

Answer 10

achieve positive fluid balance 2-3L by 6 hours

Question 11

diabetes diagnosis

Answer 11

fasting glucose >7
OGTT >11.1
random >11,1
HbA1C >48

Question 12

pre diabetes classification

Answer 12

fasting >6.1 to <7
OGTT=7.8-11.1
HbA1c=42-47
random not applicable

Question 13

normal classification

Answer 13

fasting <6.1
OGTT <7.8
random 4-7
HbA1c <41