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| ==Background==
| | #REDIRECT[[Diabetes mellitus (main)]] |
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| ==Clinical Features==
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| ==Differential Diagnosis==
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| {{Hyperglycemia DDX}}
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| ==Evaluation==
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| 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>
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| *HbA1C ≥6.5 percent
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| *FPG ≥126mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least eight hours
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| *Two-hour plasma glucose ≥200mg/dL (11.1 mmol/L) during an oral glucose tolerance test
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| *In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200mg/dL (11.1 mmol/L)
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| **Most common way diagnosed in ED
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| ==Management==
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| *1st line Metformin 500mg BID --> 1000mg BID, do not give in people with abnormal LFT's, CHF Stage 3/4 and ARI, CKD
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| *2nd Agent Glipizide start 2.5mg BID -->5mg BID, need to monitor for hypoglycemia
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| *3rd Agent Pioglitazone
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| *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
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| ===Outpatient===
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| *If HbA1c > 6.5, titrate fasting blood sugar to 80 to 120
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| *ADA diet control until HbA1c is >7
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| *all diabetes mellitus need HbA1c q 3mo, Ma-cr to check for microalbuminuria q year
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| ==Disposition==
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| *Asymptomatic patients can be discharged with follow up with primary care physician<ref>[[EBQ:Relevance of Discharge Glucose Levels]]</ref>
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| ==See Also==
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| *[[Diabetes Mellitus (Main)]]
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| *[[EBQ:Relevance of Discharge Glucose Levels]]
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| [[Category:Endocrinology]]
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| ==References==
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| <references/>
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