Special Populations

Question 1

Pediatric T1DM

Answer 1

BP: treat if consistently >130/80

Cholesterol: treat if LDL consistently >130

Microvascular monitoring once the child is ≥10 years or has had DM for 5 years

Exercise 60mins 3x/week and strength training

MNT

Question 2

Pediatric T2DM

Answer 2

Microvascular screening once the child is ≥10 years old and BMI ≥85th percentile

7-10% weight loss

Goal A1C <7%

30-60 minutes of moderate-vigorous physical activity 5x/week, strength training 3x/week

Question 3

Geriatric DM

Answer 3

Functional, cognitively intact older adults can use goals developed for younger adults, but if not…

A1C <7.5%
Avoid hypoglycemia
Consider de-escalating regimens regularly

Question 4

Sick day management

Answer 4

Continue long-acting (basal) insulin

Use rapid-acting (bolus) insulin when eating

Continue all PO meds except for metformin, GLP-1 RA, SGLT2i

Stop ALL PO meds if there is N/V/D

Check OTC meds for sugar content

Question 5

Sick day management counseling points

Answer 5

Test BG q2h

In T1DM- check urine and blood ketones q4h

Monitor temperature and hydration status

Track symptoms: N/V/D, thirst, urination