hypo/hyperglycemia Flashcards
what organs are the four in charge of blood glucose
pancreas, liver, adrenals, muscle
what are the adrenals role in blood glucose
increased cortisol, it goes to the liver and signals gluconeogenesis.
decreased cortisol means less gluconeogenesis and decreased BG, insulin works better.
what is the treatment for acute hypoglycemic crisis
50% IV dextrose 1mg/kg diluted 1:4
what are the main differentials for causes of hypoglycemia
addisons, liver disease, insulinoma, neoplasia
how does addisons cause hypoglycemia
lack of cortisol causes decrease in gluconeogenesis in the liver and no inhibition of insulin
what tests are we going to run to determine the cause of hypoglycemia
baseline cortisol, liver values, paired BG/insulin and AUS, CBC/chem for anemia
how to medically manage an insulinoma
stabilize with dextrose, give steroids, frequent small meals and diazoxide.
or surgically remove it
pu/pd, hungry, weightloss
hyperglycemia–DM?
how do you diagnose DM
fasting hyperglycemia
glucosuria, hypercholesterolemia, mild hypertriglyceridemia
treatment for hyperglycemia and DM
insulin supplementation, manage diet and exercise
how do you treat DKA compared to DM
DKA needs to get out of acidosis so we aggressively give insulin, and sugar as needed.
what is the goal in a DKA
get the patient back to DM and out of acidosis
what is the general steps to treat a DKA
give fluids first to address CV and rehydrate
give insulin until no longer acidemic
monitor BG and potassium
vomiting, lethargy, ADR history of DM
consider DKA
