🥗 FORMULAS & COMPUTATIONS: Diabetes • Dyslipidemia • CVD • DKA • HHS • Hypoglycemia
I. Diabetes Mellitus (DM)
Formula When You Need It Example Interpretation / Pearl
eAG (Estimated Avg
Glucose)eAG=28.7×HbA1c–46.7eAG=28.7×HbA
Explaining HbA1c results to
patients in “mg/dL”
HbA1c = 7.5 →
eAG ≈ 169
🎯counseling;
Easier for patient
A1c of 7% ≈
1c–46.7 mg/dL 154 mg/dL
Corrected
Na⁺Na+1.6×(Glucose–100)/100Na+1.6×(Glucose
Hyperglycemia → decide when
to switch to 0.45% NaCl
Glucose 600, Na
132 →
🎯DKA/HHS
Use corrected Na for
fluid choice
–100)/100 corrected Na ≈
140
LDL-C
(Friedewald)LDL=TC–HDL–TG/5LDL=TC–HDL–
Dyslipidemia work-up if TG <400
mg/dL
TC 220, HDL 40,
TG 200 →
🎯high-intensity
DM + LDL ≥100 =
statin
TG/5 LDL ≈ 140
II. DKA & HHS
Formula When You Need It Example Interpretation / Pearl
Anion Gap (AG) AG=Na–(Cl+HCO3)AG=Na–(Cl+HCO3) Diagnose DKA, track
resolution
Na 138, Cl 100,
HCO₃ 10 →
🎯AGDKA<12resolved when:
+HCO₃ ≥18 + pH
AG = 28 ≥7.3
Serum
OsmolalityOsm=2Na+Glucose/18+BUN/2.8Osm=2Na+Gl
Diagnose HHS, guide
correction speed
Na 148, Glu
850, BUN 30
🎯dropping
Osm >320 = HHS; avoid
>3 mOsm/hr →
ucose/18+BUN/2.8 → Osm ≈ prevent cerebral edema
354
Glucose Fall Target Adjusting insulin drip in
DKA/HHS
Aim: ↓ 50–70
mg/dL/hr
🎯insulin
If ↓ <50 mg/dL/hr → ↑
rate; if ↓ >100 →
risk cerebral edema
Fluid Deficit EstimateDeficit≈Weight×Deficit≈Weight× Plan initial resuscitation
in DKA/HHS
60 kg × 10% ×
10 ≈ 6 L
🎯hrs,
Replace ~50% in first 8
rest over 16 hrs
deficit
III. Hypoglycemia
Formula / Tool When You Need It Example Interpretation / Pearl
Whipple’s Triad Evaluate unexplained
hypoglycemia
Symptoms + glucose <55 + relief after
glucose correction
🎯“true
Must fulfill triad before calling it
hypoglycemia”
β-Hydroxybutyrate Levels Differentiate causes of
hypoglycemia
Low β-HB + insulin ↑ =
insulinoma/sulfonylurea
🎯high
Low β-HB = insulin-driven hypo;
β-HB = starvation, alcohol,
adrenal insufficiency
72-Hour Fasting Test Diagnose insulinoma Hypoglycemia + insulin ↑ + C-peptide ↑ +
suppressed β-HB
🎯before
Always confirm biochemically
imaging
IV. Insulin Dosing & Titration
Formula When You Need It Example Pearl
Total Daily Dose (TDD) 0.4–0.6U/kg/day0.4–0.6U/kg/day Starting basal-bolus
regimen
60 kg × 0.5 ≈ 30
U/day
🎯50%
Start ~50% basal,
bolus
Insulin Sensitivity Factor (ISF) ISF=1800÷TDDISF=1800÷TDD Estimate ↓ glucose per
1U insulin
TDD = 30 U → ISF
≈ 60 mg/dL/unit
🎯correctional
Helps adjust
doses
safely
Correction Bolus
(CurrentGlucose–Target)÷ISF(CurrentGlucose–Target)÷ISF
Hyperglycemia
correction
280 – 120 ÷ 60 ≈ 3
U rapid insulin
🎯last
Always confirm
dose + carb
intake
V. When You’ll Use These
Scenario Key Computation(s) Why It Matters
DKA diagnosis AG, corrected Na Confirm diagnosis, guide fluid type
DKA resolution AG + HCO₃ + pH Determines when to stop insulin drip
HHS diagnosis Osmolality, corrected Na Osm >320 confirms HHS; avoid rapid correction
Starting insulin TDD, ISF, correction bolus Prevents hypo- and hyperglycemia
Unexplained hypo β-HB, insulin, C-peptide, Whipple’s triad Distinguish insulinoma, sulfonylurea, alcohol
Dyslipidemia LDL, TG thresholds Determines statin or fibrate use
Patient counseling eAG from HbA1c Makes results easier to explain
Resident Pearls
● 🧩
🧩 Corrected Na⁺ determines when to switch fluids in DKA/HHS.
●
● 🧩
🧩
Anion gap closure + HCO₃ ≥18 + pH ≥7.3 = DKA resolved.
Osmolality >320 = HHS → lower slowly, ≤3 mOsm/hr.
●
● 🧩 LDL ≥100 in DM = high-intensity statin; TG ≥500 = fibrates first.
Always thiamine before glucose in alcohol-related hypoglycemia.