Flashcards in Small Group: Type I and II Diabetes Deck (17):
What are diagnostic tests for diabetes?
- Random glucose above 200 with symptoms
- HbA1c above 6.5%
- Fasting blood glucose over 126 mg/dL
- Two hours post 75 grams of glucose intake with a blood glucose over 200
What tests might you order in a newly diagnosed diabetic?
BMP (to assess creatinine)
Urine albumin to creatinine ratio
Many people argue that type-2 diabetics with A1cs above _____ should be started on insulin.
Guidelines now state that those with GFRs down to ______ can still be started on metformin.
How many excess calories need to be eaten to gain one pound?
For every 100 mg/dL increase in glucose, sodium needs to be correct by ________.
an increase in 1.6 mEq/L
Anion gap uses ___________ sodium.
HLA _______ are associated with type 1 diabetes.
DR3 and DR4 (DR2 is protective)
What test is used to monitor diabetic nephropathy?
Urine albumin:creatinine ratio
What is a good rule of thumb for total amount of insulin needed per day?
0.5 units per kg
Of the total insulin given per day, how much should be basal and how much prandial?
Half and half. So if a person weighs 88 kg, then they need 44 units per day, of which 22 U should be basal and 22 U should be prandial.
How do you calculate correction factor?
1650/(total daily dose of insulin) = amount of mg/dL that one unit will change
True or false: patients with type 2 diabetes that need to be NPO should cease all insulin.
False. They should cease prandial insulin but not basal, because the liver is always producing glucose.
What causes the pseudo-hyponatremia found in extreme hyperglycemia?
The sugar can pull water into the serum, thus diluting the sodium.
Why does serum phosphate fall after administering insulin?
Because many molecules will be phosphorylated (glucose and ADP), so phosphate will fall
Which should be given first to a patient with DKA, fluid or insulin?
Fluid, because insulin moves water into cells (pulled by glucose osmosis), and if they're already hypovolemic then that could precipitate shock.