Diabetes mellitus (main): Difference between revisions

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*Growing in worldwide prevalence  
*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
*Results from either inability of the body to release insulin from the pancreas or a resistance against the actions of insulin
==Clinical Features==
*Patients with diabetes may be asymptomatic
*Acute symptoms may range from those of [[nonketotic hyperglycemia]] (e.g. polyuria, polydipsia) to [[DKA]] (ill appearance, acetone breath, Kussmaul's breathing, somnolence)


==Differential Diagnosis==
==Differential Diagnosis==

Revision as of 02:44, 10 November 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

Clinical Features

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

Differential Diagnosis

Hyperglycemia

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