Up And Down
Endocrine System
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{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M1_F1.jpg"}},{"insert":"\n\n"},{"insert":"It is close to lunchtime. You are halfway through your paperwork, when an elderly lady is wheeled in.\n\nShe introduces herself as 60-year-old Mrs. Patel, and says that her left leg has been swollen and painful since last night.\n\nShe was diagnosed with diabetes 10 years ago, and has been on oral hypoglycemics since.\n\nHer son, Rahul, adds that her glycemic control has often been unsatisfactory, as she has a \u0027sweet tooth\u0027.\n\nThere is no history of previous thrombotic events, or of risk factors for deep venous thrombosis.\n"}]}
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{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M1_F2.jpg"}},{"insert":"\n\n"},{"insert":"Mrs Patel\u0027s temperature is 100.4 \u00b0F (38 \u00b0C).\n\nHer left leg is erythematous, swollen and tender to touch. A wound 1 cm x 2 cm in size is noted in the first web space. No inguinal lymphadenopathy is present.\n\nHer random capillary glucose is 245 mg\/dL (13.6 mmol\/L).\n\nYou decide to admit her, and start treatment with intravenous (IV) antibiotics. You also switch her to subcutaneous insulin.\n"}]}
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{"ops":[{"insert":"What is your glycemic control strategy?\n"}]}
1. Keep her random blood glucose levels below 140 mg/dL (7.8 mmol/L)
2. Keep her random blood glucose levels below 180 mg/dL (10.0 mmol/L)
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