Non-insulin-dependent diabetes mellitus: diagnostic and therapeutic challenges in the severely burned patient--a case report.
The purpose of this paper is to describe the management of a previously undiagnosed non-insulin-dependent diabetic patient with a severe burn injury. The hyperglycaemia and glucose intolerance following burn injury was complicated by the hyperglycaemia of diabetes mellitus. Intravenous insulin infusion monitored by hourly glucose levels was required to manage this hyperglycaemia. During day 11 postburn injury, this patient required 2104 units of insulin to control his hyperglycaemia. Aggressive detection and management of infections complemented by early debridement and coverage of the burn wound were other important considerations in the management of this patient. The diagnosis of non-insulin-dependent diabetes mellitus (NIDDM) was made after the patient recovered from his burn injury. His rehabilitation programme has included primary prevention strategies for NIDDM that focus on health-improving behaviours such as improved diet, exercise, and weight control.
Park
S M
SM
Ira W. DeCamp Burn Center, Department of Plastic Surgery, University of Virginia School of Medicine, Charlottesville.
Zachmann
G C
GC
Holliday
W L
WL
Fryburg
D A
DA
Edlich
R F
RF
Himel
H N
HN
D000328:Adult; D002056:Burns / Q000150:complications* / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000628:therapy*; D003937:Diagnosis, Differential; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis / Q000188:drug therapy; D007328:Insulin / Q000008:administration & dosage; D008297:Male
D007328:Insulin