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Case Presentation
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Identifying Data
Name : 류 O 수
Age / sex : 47 / M
Date of admission : 2xxx. 2. 16
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Chief Complaint
“혈당이 너무 높아서 왔습니다.”
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Present Illness
내원 2개월 전 부터 다뇨, 다음, 야간뇨 증상 발생했고, 그 동안 체중이 10kg 감소. 치료는 받지 않았음.
2xxx년 2월 13일 타병원에서 시행한 혈당검사에서 500mg/dL이상이 나와서 경구혈당강하제 복용하다가 2월 16일 본원 외래를 통해 입원.
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Past History
DM - new onset
HTN, Hepatitis, Pul. Tbc, Neoplasm, Allergy - all denied by patient
Operation history operation for Left knee ligament rupture(군복무 시절)
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Social History
Occupation : 학원차량 운전
Smoking (+): 1pack/day for 30years
Alcohol (+): 2병/1회/1month
Family History
DM, HTN denied by patient
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Review of System
General
General weakness/fatigue
(-/+)Fever / Chill (-/-) Body weight change ( 10kg loss for 2months )
Head
Headache/Facial edema(-/-)
Dizziness (-)
…(생략)
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Abdomen U/S
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Diagnosis
Diabetes Mellitus
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Treatment Plan
당뇨 식이요법
당뇨 교육
운동
약물: Insulin+ Sulfonylurea, Biguanide
합병증의 검사 및 예방
- 안저검사
- 미세 알부민뇨 검사
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Text Review
-Insulin therapy-
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Type 1 DM에서의 인슐린 치료
In general, individuals with type 1 DM require 0.5~2.0U/kg/day of insulin
With ~50% of the insulin given as basal insulin
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Multiple-component insulin regimens
Combination of basal insulin and bolus insulin(preprandial short-acting insulin)
Basal insulin
-glargine or detemir
Bolus insulin
-lispro, glulisine, or insulin aspart
Offer the patient with type 1 diabetes more flexiblity in terms of lifestyle and the best chance for achieving near normoglycemia
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Twice-daily injection
One commonly used regimen
A Long-acting insulin like NPH mixed with a short-acting insulin before the morning and evening meal.
2/3 of the total daily insulin dose in the morning(2/3 long-acting
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