Hyperglycaemia Flashcards
what values of HbA1c, fasting glucose, random glucose, OGTT classify diabetes?
HbA1C >48
fasting glucose >7
random glucose & OGTT >11.1
what is needed for diabetes diagnosis?
symptomatic + 1 of the above tests
asymptomatic + repeat test
what OGTT or fasting glucose indicates impaired glucose tolerance/impaired fasting glucose?
OGTT between 7.8 and 11.1
fasting glucose between 6.1 and 7
what do you use if you want to see snapshot of control over last 3 weeks?
frutosamine
what is needed if you want to see snapshot of control over last 3 months
HbA1C
what is a cause of episodic diarrhoea in a long term diabetic
autonomic neuropathy
what is needed for diagnosis of DKA
pH <7.3
plasma glucose >11
blood ketones >3 (2+ in urine)
symptoms of DKA
confusion, abdominal pain, Kussmaul breathing (deep/laboured breathing), nausea/vomiting
what can precipitate DKA?
infection, surgery, missed insulin doses, trauma
how to treat DKA
1) fluids 0.9% NaCl (if in shock, bolus, if not 1litre over 1 hour), if K+ btn 3.5-5.5 add KCl to 2nd litre of fluids
2) insulin 0.1u/kg/hr after fluids
3) once glucose <14 add 10% dextrose
monitor glucose & potassium hourly
what is needed for HHS diagnosis
pH >7.3
omsolarity >320
blood glucose >30
develops over days
presentation of HHS
confusion & dehydration
management of HHS
1) IV fluids 0.9% over 1 hour
2) if >1 ketones 0.05u/kg/hr fixed rate
monitor U&Es and glucose
what inheritance pattern in MODY
autosomal dominant
what are rapid acting insulin examples and its use
lispro
aspart
glulisine
used to replace insulin after meals
*LAG - rapid doesn’t lag
