Risk factors for type 2 risk obesity acanthosis

Info iconThis preview shows page 1. Sign up to view the full content.

View Full Document Right Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: do you What want? want? • 2AM blood sugar is 122 • Dawn phenomenon • To correct: Move evening NPH to To bedtime bedtime Case 2 Case • What if 2AM blood sugar was 59? • Somogyi phenomenon – rebound Somogyi hyperglycemia after hypoglycemia hyperglycemia • Treatment: decrease evening NPH Mary Tyler Moore Mary Type 1 diabetes Case 3 Case • 13 y/o black female, 2 week h/o polyuria, 13 polydipsia, 16 lb weight loss polydipsia, • Overweight, BMI 97% • Acanthosis nigricans on neck • 2 grandparents have type 2 diabetes Case 3 Case • • • • Initial glucose – 634 mg/dl Bicarb – 18 mmol/l UA >80 mg/dl ketones Serum ketones – negative • Type 1 or type 2? Risk Factors for Type 2 Risk • • • Obesity Acanthosis nigricans Family history • Maternal gestational diabetes Case 3 Case • • • • Islet cell antibodies – positive Anti-GAD 65 – positive Insulin antibodies – negative C-peptide - <0.5 • Type 1 Sick Day Management Sick • Never omit insulin • Insulin requirements are often greater Insulin with illness with • Hypoglycemia may be a problem, Hypoglycemia especially in younger children especially • Test blood sugars every 2-4 hours • Check urine ketones Sick Day Management Sick • Drink plenty of fluids (1 cup per hour) – Sugar-containing liquids for hypoglycemia • Need extra insulin to clear ketones – NPH/R: extra 20% of total dose as R q4 NPH/R: hours hours – Basal/bolus: correction dose q3 hours + Basal/bolus: additional 20% of calculated correction additional • ED for persistent vomiting Halle Berry Halle Actress Type 1 diabetes CGMS New Directions: Inhaled Insulin New PREP Questions PREP Question Question Which of the following statements regarding the Which development of type 1 diabetes is true? development A. Administration of parenteral insulin to those at risk has A. been proven to decrease the likelihood of developing diabetes diabetes B. HLA typing has not been shown to be useful in B. determining the risk of devel...
View Full Document

This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

Ask a homework question - tutors are online