Diabetes mellitus (main): Difference between revisions

Revision as of 03:57, 10 November 2018

Growing in worldwide prevalence
Results from either inability of the body to release insulin from the pancreas or a resistance against the actions of insulin

Patients with diabetes may be asymptomatic
Acute symptoms range from those of nonketotic hyperglycemia (e.g. polyuria, polydipsia) to DKA (ill appearance, acetone breath, Kussmaul's breathing, somnolence)

Diabetes mellitus itself is not normally a diagnosis sought in the emergency department (i.e. via A1C)
Hyperglycemia can be found on laboratory testing
- Asymptomatic patients do not necessarily require additional testing
- Symptomatic or potentially symptomatic patients require additional testing
  - Check CBC, BMP, and ketones (if sick, additionally see DKA workup)
  - UA is only necessary if you are ruling out urinary infection or do not have serum ketones available and are using it as a screening mechanism

May consider IV hydration or IV insulin administered in the ED
All patients with diabetes newly diagnosed in the ED will require reliable follow-up for education and blood sugar monitoring
May consider discharging patient with prescription for metformin, starting dose is 850 mg daily

@@ Line 15: / Line 15: @@
 **Asymptomatic patients do not necessarily require additional testing
 **Symptomatic or potentially symptomatic patients require additional testing
-***Check CBC, BMP, and ketones (if sick see additionally [[DKA]] workup)
+***Check CBC, BMP, and ketones (if sick, additionally see [[DKA]] workup)
 ***UA is only necessary if you are ruling out urinary infection or do not have serum ketones available and are using it as a screening mechanism