Card Set Information
Criteria for a diagnosis of diabetes
Fasting glucose over 126, measured on 2 separate occasions
Random glucose over 200
HbA1c over 6.5% on two separate occasions
Treatments goals for diabetes
Postprandial glucose under 180 mg/dL
Fasting glucose between 70-130 mg/dL
HbA1c under 7% (HbA1c is approximately equal to 20x the average glucose level over the past 3 months)
Two most common causes of DKA
Common presenting symptoms of diabetes
Polyuria, polydipsia, polyphagia
What is diabetic gastroparesis, and how is it treated?
Impaired autonomic NS prevents the stomach from emptying properly after meals, leading to early satiety, nausea, and vomiting
Treat with motolity agents like metoclopramide
Timeframe of NPH
Starts to work in 1--1.5 hours
Peaks at 6--8 hours
Total duration of 12--20 hours
What is the Somogyi effect?
A physiological reaction to hypoglycemia that typically occurs in diabetics whose insulin doses are too high
Hypoglycemia triggers release of stress hormones such as cortisol and glucagon that raise blood sugar
Patients present with high 7 AM glucose; management is to reduce nighttime insulin dose
What is the dawn phenomenon?
Early morning hyperglycemia, due to physiologic morning release of GH
Unlike in the Somogyi effect, where 3 AM glucose is low, in the dawn phenomenon, 3 AM glucose will be normal or high
Treat by increasing evening insulin dose (unlike Somogyi, where you decrease the evening dose)
How should the insulin dose of a diabetic be adjusted if the patient is NPO before surgery?
Give 1/3--1/2 the normal dose