DRAFT
Department of Emergency Medicine
UNC Hospitals
July, 2001
Policy: Initial ED management of hyperglycemic, non-diagnosed diabetics
Procedure:
I. Random BS 160-250
Followup instructions for screening with FBG
II. Random BS 250-350 (no acute dietary indiscretions such as drinking quarts of sugary drinks or IV containing glucose)
Treat in ED with first dose of Glucotrol (glipizide) 5 mg or Amaryl (glimepiride) 2 mg po; contraindication to both drugs is SULFA allergy
Give prescription for Glucotrol (glipizide) 5 mg po qd or Amaryl (glimepiride) 2 mg po qd to begin next day
Followup 24 hours with PMD
III. Random BS >350
Treat in ED with regular insulin, 0.1unit/pound, accucheck in 1 hour to determine effectiveness
Give prescription for Glucotrol (glipizide) 5 mg po qd or Amaryl (glimepiride) 2 mg po qd each morning.
Followup 24 hours with primary care MD or call endocrine fellow to arrange followup.
Judith Tintinalli, MD, MS
Professor and Chair
Approved: Faculty Meeting, July 10, 2001
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