2nd internal Answer sheet
Prefinal exam OSCE
Case : A 77 yr old female with uncontrolled diabetes mellitus OSCE questions: 1) Steroid induced diabetes mellitus Steroid-induced diabetes mellitus is defined as an abnormal increase in blood glucose associated with the use of glucocorticoids in a patient with or without a prior history of diabetes mellitus. The criteria for diagnosing diabetes by the American Diabetes Association is 8 h fasting blood glucose ≥ 7.0 mmol/L (126 mg/dL), 2 h post 75 g oral glucose tolerance test (OGTT) ≥ 11.1 mmol/L (200 mg/dL), HbA1c ≥ 6.5% or in patients with symptoms of hyperglycemic, a random plasma glucose of ≥ 11.1 mmol/L (200 mg/dL) . The effect of glucocorticoids on glucose metabolism is likely the result of impairment of multiple pathways including beta cell dysfunction (sensitivity to glucose and ability to release insulin) and insulin resistance in other tissue. RISK FACTORS: Proposed risk factors for steroid-induced diabetes beyond cumulative dose and longer duration of steroid cou
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