Nonketotic hyperglycemia

Background

  • Typically defined as glucose >180

Clinical Features

Differential Diagnosis

Hyperglycemia

Evaluation

  • Elevated glucose
  • May check:
    • CBC
    • Chemistry (gap)
    • Ketones

Management

Type II Diabetes Outpatient Management

  • 1st line: Metformin 500mg BID → 1000mg BID, do not give in people with abnormal LFT's, CHF Stage 3/4 and ARI, CKD
  • 2nd Agent: Glipizide start 2.5mg BID → 5mg BID, need to monitor for hypoglycemia
  • 3rd Agent: Pioglitazone
  • After 3 agents: need to start insulin if not controlled
    • NPH BID or Lantus Qday (0.5mg/kg) and titrate to Fasting Blood Sugar

Disposition

  • Asymptomatic patients can be discharged with follow up with primary care physician[1]

See Also

External Links

References