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Case Presentation
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Identifying Data
Name : 瑜� O �닔
Age / sex : 47 / M
Date of admission : 2xxx. 2. 16
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Chief Complaint
��쒗삁�떦�씠 �꼫臾� �넂�븘�꽌 �솕�뒿�땲�떎.���
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Present Illness
�궡�썝 2媛쒖썡 �쟾 遺��꽣 �떎�눊, �떎�쓬, �빞媛꾨눊 利앹긽 諛쒖깮�뻽怨�, 洹� �룞�븞 泥댁쨷�씠 10kg 媛먯냼. 移섎즺�뒗 諛쏆�� �븡�븯�쓬.
2xxx�뀈 2�썡 13�씪 ���蹂묒썝�뿉�꽌 �떆�뻾�븳 �삁�떦寃��궗�뿉�꽌 500mg/dL�씠�긽�씠 �굹����꽌 寃쎄뎄�삁�떦媛뺥븯�젣 蹂듭슜�븯�떎媛� 2�썡 16�씪 蹂몄썝 �쇅�옒瑜� �넻�빐 �엯�썝.
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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(援곕났臾� �떆�젅)
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Social History
Occupation : �븰�썝李⑤웾 �슫�쟾
Smoking (+): 1pack/day for 30years
Alcohol (+): 2蹂�/1�쉶/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 (-)
GI System Anorexia(-) Nausea / vomiting(+/-)
Urinary System Dysuria (-) Frequency/Urgency(-/-)
Respiratory Sy���(�깮�왂)
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Abdomen U/S
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Diagnosis
Diabetes Mellitus
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Treatment Plan
�떦�눊 �떇�씠�슂踰�
�떦�눊 援먯쑁
�슫�룞
�빟臾�: Insulin+ Sulfonylurea, Biguanide
�빀蹂묒쬆�쓽 寃��궗 諛� �삁諛�
- �븞���寃��궗
- 誘몄꽭 �븣遺�誘쇰눊 寃��궗
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Text Review
-Insulin therapy-
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Type 1 DM�뿉�꽌�쓽 �씤�뒓由� 移섎즺
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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