Inpatient DM Flashcards
When should i check A1c?
Hyperglycemia > 140 mg/dL (without diagnosis of diabetes)
Not already done in last 3 months
What is glucose target for most pts?
140-180 mg/dL
What is premeal glucose target?
Premeal should be less than 140 and random less than 180
What is the preferred insulin tx?
Basal-Bolus
Is underdosing insulin better or over-dosing?
Underdosing, hypoglycemia
T/F If Hypoglycemia Occurs change you insulin orders
True
What are the hypoglycemia RF?
- Renal insufficiency (AKI, dialysis so they don’t go into hypoglycemia.
- Liver disease
- Altered nutrition (If NPO, make insulin orders less)
- History of severe hypoglycemia
Which med causes Hypoglycemia Risk Factors
Sulfonylureas
How is insulin cleared from the body?
Renally
Which med should you not pescribe to pt with underlying renal dz?
Sulfonylureas
Review slide 11
Hypoglycemia treatment
- Oral glucose
- IM/SC glucagon- Maximum effect a few minutes after giving
- IV D50W- Need IV access, hyperosmolar, tissue necrosis if infiltrated
Insulin management?
Long acting for basal the bolus (rapid-acting insulin
Sliding is no basal and just only paid-acting insulin
What are basal bolus example?
Lantus 10 units HS
+ Lispro 3 units qAC
+ Lispro correction scale qAC
What are SSI example?
Lispro correction scale qAC
