Diabetes mellitus (main): Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Hyperglycemia DDX}} | {{Hyperglycemia DDX}} | ||
*In established diabetics presenting with hyperglycemia ask about medication and dietary compliance | |||
==Evaluation== | |||
Workup based on provider level of suspicion for emergent process such as DKA, HHS, sepsis | |||
*In asymptomatic patient may consider UA to check for ketones | |||
*Sick patients will require CBC, BMP, blood gas, EKG, additional tests at provider discretion | |||
==Management== | |||
*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 | |||
==See Also== | ==See Also== | ||
Revision as of 18:30, 11 October 2018
Background
- 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
Differential Diagnosis
Hyperglycemia
- Physiologic stress response (rarely causes glucose >200 mg/dL)
- Diabetes mellitus (main)
- Hemochromatosis
- Iron toxicity
- Sepsis
- In established diabetics presenting with hyperglycemia ask about medication and dietary compliance
Evaluation
Workup based on provider level of suspicion for emergent process such as DKA, HHS, sepsis
- In asymptomatic patient may consider UA to check for ketones
- Sick patients will require CBC, BMP, blood gas, EKG, additional tests at provider discretion
Management
- 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