Crisis Mode
Two predominant inpatient hyperglycemic crises?
What are Diabetic ketoacidosis (DKA) & Hyperglycemic Hyperosmolarity Absence of significant ketonemia or acidosis (HHS)
Byproducts of lipid breakdown
What are ketones?
Whipple's Triad criteria
What are: low plasma glucose, signs/symptoms of hypoglycemia and resolution of hypoglycemia after treatment?
Pre-meal blood glucose target for non-critically ill, hospitalized patients.
What is 100-180 mg/dL?
Most potent commonly used steroid (e.g. low dose produces large effect on BG)
What is dexamethasone?
Three diagnostic criteria for DKA
What are: BHB > 3mmol/L, venous pH <7.3, HCO3 <18
Three conditions that promote ketogenesis
What are: insulin deficiency, insulin resistance, starvation?
Counter-regulatory hormones responsible for physiologic hypoglycemia response (list at least 3 of 4).
What are: growth hormone, cortisol, catecholamines, glucagon?
Blood glucose target for critically-ill patients.
What is 140-180 mg/dL?
Glucocorticoids affect this type of blood sugar most
What is post-prandial or mealtime blood sugar?
Four diagnostic criteria for HHS
What are: BG >600 mg/dL, BHB <3 mmol, venous pH >7.3, HCO3 >15 mmol/L, total serum osm >320 mOsm/kg (calculated effective >300 mOsm/kg)
This ketone body is cleared more slowly than beta-hydroxybutyrate
What is acetocetate?
Rule of 15/15
What is 15 grams of carbohydrates and recheck blood sugar with capillary glucose check in 15 minutes?
Blood glucose target for individuals after cardiac surgery
What is 110-140 mg/dL?
Individuals with this type of organ dysfunction are more likely to develop fasting hypoglycemia on Prednisone therapy
What is hepatic or renal dysfunction?
Incidence of DKA among invididuals with T2DM
What is 34%?
Percent of patients presenting with HHS who have a concurrent AGMA
What is 50%?
Carbohydrate sources used for the treatment of acute hypoglycemia without loss of consciousness (list at least 3 with exact quantities)
What are: 3-4 glucose tablets, 4 oz of juice, 4 oz of soda, 1 Tbs honey/sugar water, jelly, 5-6 jelly beans
IV insulin infusion should be initiated at this blood sugar level in patients with acute MI
What is 180 mg/dL?
This type of insulin is particularly effective for cycled overnight tube feeding related hyperglycemia
What is NPH?
7 I's of acidosis etiology
What is:
•Insulin deficiency
•Iatrogenic
•Infection
•Inflammation
•Ischemia or infarction
•Intoxication
Inhibitors: SGLT2i
Etiology of acidosis after AG has closed
What is hyperchloremic acidosis (expansion acidosis) related to fluid replacement with NS and renal losses of HCO3?
Glucagon formulations (3)
What are auto-injector, intra-nasal, intramuscular
For acutely ill patients, this blood glucose level is associated with increased length of stay and mortality
What is 200 mg/dL?
For patients on TPN, this type of insulin can be added to assist with managing hyperglycemia related to dextrose in TPN bag
What is regular insulin?