New onset diabetes mellitus: Difference between revisions

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==Diagnosis==
#REDIRECT[[Diabetes mellitus (main)]]
American Diabetes Association Diagnostic Criteria. Need 1 of the following criteria.<ref>American Diabetes Association. Standards of medical care in diabetes--2013. Diabetes Care 2013; 36 Suppl 1:S11.</ref>
*HbA1C ≥6.5 percent
*FPG ≥126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least eight hours
*Two-hour plasma glucose ≥200mg/dL (11.1 mmol/L) during an oral glucose tolerance test
*In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200mg/dL (11.1 mmol/L)
**Most common way diagnosed in ED
 
==Differential Diagnosis==
{{Hyperglycemia DDX}}
 
==Management==
*If HbA1c > 6.5, titrate fasting blood sugar to 80 to 120
*ADA diet control until HbA1c is >7
*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, ie NPH BID or Lantus Qday (0.5mg/kg) and titrate to Fasting Blood Sugar
*all DM need HbA1c q 3mo, Ma-cr to check for microalbuminuria q year
 
==See Also==
*[[Diabetes Mellitus (Main)]]
 
[[Category:Endocrinology]]
 
==References==
<references/>

Latest revision as of 04:16, 10 November 2018