Glycemic Management

Question 1

why are oral diabetes meds held in inpatient usually?

Answer 1

metformin- risk of lactic acidosis

Question 2

inpatient glycemic goal on floor

Answer 2

fasting < 140

random or post prandial < 180

Question 3

ICU goal for blood sugar

Answer 3

more generous

Question 4

rapid acting insulin

Answer 4

lispro, aspart, glulisine

Question 5

short acting insulin

Answer 5

regular insulin

Question 6

intermediate acting insulin

Answer 6

NPH

Question 7

long acting insulin

Answer 7

insulin glargine, detemir

Question 8

inpatient glycemic control best with _____ insulin regimen

Answer 8

basal bolus

for basal metabolic requirements, scheduled in AM and or PM,

for bolus - (shorter acting, prandial for meals and correctional)

Question 9

how to newly start insulin on inpatient

Answer 9

calc total daily dose (wt kg x 0.5)

make half basal half bolus

Question 10

name some triggers for diabetic emergency (clue I’s

Answer 10

infection
inflammation
insulin non adherence
iatrogenic

Question 11

DKA protocol order

Answer 11

VOLUME VOLUME VOLUME with IVF
then start repleting K
then give insulin

Question 12

patient is diaphoretic, obtunded, glucose 42…rx?

Answer 12

IM glucagon!, if not obtunded…can do PO glucose gel, juice, crackers