What is the treatment for diabetes mellitus in the ED when the type is unknown?

Updated: Oct 23, 2019
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

When dealing with patients with known diabetes in the emergency department, distinguishing the type of diabetes can be difficult in 2 groups: (1) patients who are treated with insulin and are young but clinically appear to have type 2 diabetes, and (2) older patients with late-onset of diabetes who nonetheless take insulin and seem to share characteristics of patients with type 1 diabetes. (This latter group is now said to have latent autoimmune diabetes of the adult [LADA]).

When in doubt, the emergency department patient should be treated with insulin and his or her glucose levels should be closely monitored. Some adolescents or young adults, mostly Hispanic or African American patients, who present with classic DKA are subsequently found to have type 2 diabetes.


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