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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