HYPERGLYCEMIA

Question 1

WHO IS DIABETIC

Answer 1

2X OVER 200

OR AM OVER 126 / OR 126

Question 2

hypoglycemia associated complications

Answer 2

• arrhythmias
• increased mortality of 1 year period
• LOS longer
• sudden death in type 1

Question 3

inpatient - when to start ISS in patient with known DM2

Answer 3

• SUGAR OVER 140

Question 4

TARGET LEVEL

Answer 4

PRE MEAL 140 OR LESS
RANDOM 180 OR LESS
CRITICALLY ILL 180 OR LESS

Question 5

BASAL BOLUS VS ISS

Answer 5

RABBIT TRIAL - BOLUS IS AS EFFECTIVE AS ISS

Question 6

INSULIN DOSING

Answer 6

0.3-.06. – 0.5/ KG 0.1 LESS FOR RENAL, LIVER, PANCREATIC IMPAIRMENT, AGE 70 OR MORE
0.1 ADD EXTRA STEROIDS; A1C 10%,
ELEDERLY 0.3

Question 7

TDD SPLIT

Answer 7

50:50

1500/ TDD = 1 unit correction

Question 8

rate of adjustment

Answer 8

140-180 10%

180 or more 20%

Question 9

which insulin to use if on steroids

Answer 9

NPH - COVERING INCREASING GLUCOSE AS DAYS GO ON
EXTRA 0.1
BOLUS DOSING CAN GO THROUGH THE DAY 4-6-10 EG

Question 10

DKA

Answer 10

D - GLUCOSE OVER 250
K - KETONURIA
A- ACIDOSIS BICARB BELOW 18 OR pH BELOW 7.3

Question 11

hold iv insulin for DKA if K level is

Answer 11

below 3.3

Question 12

iv to sq in dka

Answer 12

if bicarb over 18

overlap 2 hr basal

Question 13

discharge treatment

Answer 13

<8% – restart OP
8-10% –restart oral and add on basal 50% of hospital dose
10%> –80% basal bolus of hospital dose and restart oral