Diabetes Mellitus Exam Test with Verified Answers Graded A+
1. Dawn Phenomenon: Normal glucose until 2-8 am when it risis. Results from de-
creased insulin sensitivity and nightly surge of counterregulatory hormones during
nighttime fasting
2. Treat with bedtime injection of NPH to blunt morning hyperglycemia, avoid-
ing carbohydrate snack late at night: Treatment of Dawn Phenomenon
3. Somogyi effect: Nocturnal hypoglycemia followed by rebound hyperglycemia
due to surge in growth hormone
4. Treat with decreased nighttime NPH dose or give bedtime snack: Treatment
of Somogyi effect
5. Insulin waning: progressive rise in glucose from bed to morning
6. Treat with change of insulin dose to bedtime: Treatment of Insulin waning
7. DKA: Fruity breath, weight loss, rapid respirations, hypotension
8. Diabetic ketoacidosis (DKA) should always be handled in a hospitalized
setting, usually an intensive care unit, and often with an endocrinologist's
consultation, if appropriate.
TREAT WITH FLUIDS! Patients with DKA are always dehydrated and need
large-volume IV fluid resuscitation, usually isotonic fluids such as normal
saline. If corrected serum sodium level is high, this can be reduced to half-nor-
mal saline. Insulin should always be administered by an IV pump to guard
against accidental overdose.: Treatment of DKA
9. between 70 and 100: Normal fasting glucose
10. - Fasting blood glucose > 126 mg/dl fasting at least 8 hours on two
occasions GOLD STANDARD!
- Hemoglobin A1C > 6.5 indicates average blood sugar 10-12 weeks prior to
measurement
- 2 hour plasma glucose of > 200 on an oral glucose tolerance test (3 hour GTT
is gold standard in gestational diabetes mellitus)
- Random plasma glucose > 220 in patients with classical symptoms of
hyperglycemia: Diagnostic criteria for DM Type II
11. A1C 5.7-6.4, Fasting glucose 100-125, 2-hour oral glucose tolerance test
140-199: Diagnostic criteria for prediabetes
12. A1C < 7.0 % check every 3 months if not controlled and 2x per year if
controlled: A1C goal
13. Preprandial glucose 80-110 (60-90 if pregnant): Preprandial glucose goal
14. Postprandial blood glucose goal is < 140: Postprandial blood glucose goal
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1. Dawn Phenomenon: Normal glucose until 2-8 am when it risis. Results from de-
creased insulin sensitivity and nightly surge of counterregulatory hormones during
nighttime fasting
2. Treat with bedtime injection of NPH to blunt morning hyperglycemia, avoid-
ing carbohydrate snack late at night: Treatment of Dawn Phenomenon
3. Somogyi effect: Nocturnal hypoglycemia followed by rebound hyperglycemia
due to surge in growth hormone
4. Treat with decreased nighttime NPH dose or give bedtime snack: Treatment
of Somogyi effect
5. Insulin waning: progressive rise in glucose from bed to morning
6. Treat with change of insulin dose to bedtime: Treatment of Insulin waning
7. DKA: Fruity breath, weight loss, rapid respirations, hypotension
8. Diabetic ketoacidosis (DKA) should always be handled in a hospitalized
setting, usually an intensive care unit, and often with an endocrinologist's
consultation, if appropriate.
TREAT WITH FLUIDS! Patients with DKA are always dehydrated and need
large-volume IV fluid resuscitation, usually isotonic fluids such as normal
saline. If corrected serum sodium level is high, this can be reduced to half-nor-
mal saline. Insulin should always be administered by an IV pump to guard
against accidental overdose.: Treatment of DKA
9. between 70 and 100: Normal fasting glucose
10. - Fasting blood glucose > 126 mg/dl fasting at least 8 hours on two
occasions GOLD STANDARD!
- Hemoglobin A1C > 6.5 indicates average blood sugar 10-12 weeks prior to
measurement
- 2 hour plasma glucose of > 200 on an oral glucose tolerance test (3 hour GTT
is gold standard in gestational diabetes mellitus)
- Random plasma glucose > 220 in patients with classical symptoms of
hyperglycemia: Diagnostic criteria for DM Type II
11. A1C 5.7-6.4, Fasting glucose 100-125, 2-hour oral glucose tolerance test
140-199: Diagnostic criteria for prediabetes
12. A1C < 7.0 % check every 3 months if not controlled and 2x per year if
controlled: A1C goal
13. Preprandial glucose 80-110 (60-90 if pregnant): Preprandial glucose goal
14. Postprandial blood glucose goal is < 140: Postprandial blood glucose goal
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