ENDOCRINE [5 Questions] Type 1 Diabetes Mellitus o “Insulin deficient” o Insulin levels will be LOW o Destruction of beta cells in the pancreas o Idiopathic o Clinical Manifestations: �... �� 3 P’s Polydipsia Polyuria Polyphagia Weight loss Elevated glucose (200 mg/dL or more) Ketones o Diagnostic Criteria Fasting glucose >126 Random glucose >200 & symptomatic Hgb A1C >6.5% Normal is 4-6% To prevent long term complications want it below 7% o Treatment Insulin replacement Rapid Acting (Humalog, Novolog, Apidra, Lispro) o Onset: 0-15 min o Peak: 30-90 min o Duration: 3-5 hours o Take with/right before meals! Short Acting (Regular and Velosolin) o Onset: 30 min o Peak: 2-4 hours o Duration: 4-8 hours Intermediate Acting (NPH and Lente) o Onset: 2-6 hours o Peak: 4-14 hours o Duration: 14-20 hours Long Acting/basal (Lantus, Ultralente and Levemir) o No peak o Duration: 20-24 hours Set dose regimen Used for a kid who is expected to eat a set number of carbs at each meal and snack NPH and Regular insulin is used Before breakfast and dinner Timing is crucial and strict schedule for meals and injection [Show More]
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