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Diabetes

HOW SWEET ARE YOU?

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Diabetes

Diabetes is a disease caused by the inadequate production of insulin

Insulin Shock (hypoglycemia at it’s worse case) results from too much insulin in the blood, causing low sugar levels for the brain and nervous systems

Diabetic Coma (hyperglycemia at it's worse case) results from an inadequate insulin supply that leads to unconsciousness, coma and death if not treated

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Diabetes is Managed,But it Does Not Go Away.

GOAL:

To maintain target blood

glucose

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Diabetic Coma (Hyperglycemia)

Hyperglycemia is a lack of insulin, this causes too much sugar in the blood and not enough in the cells

Causes: Too much food Not taken insulin Insulin facilitates the transport of sugar

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Diabetic Coma (Hyperglycemia)

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Diabetic Coma (Hyperglycemia)

Signs and Symptoms… Rapid deep breathing Rapid weak pulse Decreased level of consciousness Dehydrated (dry), warm skin Sweet or fruity, (acetone) odor on breath Dry mouth and intense thirst Increasing restlessness, confusion This onset of this condition is gradual over

a period of days

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Diabetic Coma (Hyperglycemia)

Care for the Patient… Keep at rest in position of comfort Obtain a good history (meals, insulin) High flow O2 Reassurance If unsure whether insulin shock or diabetic coma, give

glucogel or instagel if patient has a patent airway Monitor vital signs Transport the patient to advanced medical care

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Insulin Shock (Hypoglycemia)

There is too much insulin, causing a lack of sugar in the blood.

Some causes are: Not enough food Too much insulin Excessive exerciseInsulin facilitates the transport of sugar

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Insulin Shock (Hypoglycemia)

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Insulin Shock (Hypoglycemia)

Signs and Symptoms… Normal breathing Rapid, full pulse Decreased or altered level of consciousness Pale, moist skin (sweaty at times) Dizziness, headache Fainting Seizures Disorientation Coma This onset of this condition is sudden, can occur

within minutes

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Insulin Shock (Hypoglycemia)

Care for Patient Keep at rest – position of comfort S-A-M-P-L-E history (Insulin, meals, etc.) High flow O2 Monitor vital signs Nothing by mouth, unless their alert If unsure whether insulin shock or diabetic

coma, give the patient instagel or glucogel Transport patient to advanced care

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Constant Juggling:

Insulin/medication

with:

Exercise

Food intake

Diabetes Management 24/7

BGBG

BGBG

BGBG&

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Diabetes

Gestational diabetes

Some women may develop gestational diabetes during pregnancy. These women are non-symptomatic before the pregnancy. Generally, glucose levels will return to normal after the pregnancy, although there is a higher risk of developing diabetes later in life

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Diabetes

There are many risk factors for diabetes, including:

A parent, brother, or sister with diabetesobesity Age greater than 45 yearsSome ethnic groups (particularly African-

Americans, and First Nation)

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Diabetes

Gestational diabetes or delivering a baby weighing more than 9 pounds

High blood pressure High blood levels of triglycerides (a type

of fat molecule)High blood cholesterol level

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Diabetes

Measuring Glucose Level

Blood Glucose Level (BGL) is measured in millimoles per litre (mmol/l), and a normal BGL ranges from 4 mmol/l to 7 mmol/l. Hypoglycemia is most often defined as a BGL of less than 4 mmol/l, whereas hyperglycemia is defined as a BGL of greater than 7 mmol/l.

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Diabetes

To accurately check someone’s BGL, use a device called a glucometer. Use this reading, along with a patient’s history and any signs and symptoms found during assessment, to determine whether to treat the situation as a diabetic emergency.

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Diabetes

How to use the GlucometerPrepare the lancet and lancet deviceLet the patient’s arm hang to the side if

possibleRemove a new test strip from the vial

and insert it into the deviceMatch the code number on the screen to

that of the test strip vial

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Diabetes

Cleanse the finger and force blood to the finger by squeezing the finger

Prick the side of the finger and gently squeeze out a drop of blood

Drop the blood onto the test strip in the appropriate place, cover lancet site with a Band-Aid

Record the BGL reading Remove the test strip and dispose into a

biohazard bag

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QUESTIONS

51481:  Which of the following is a common sign or symptom of a patient experiencing a diabetic emergency?

A: Slow pulse

B: Pale, clammy skin

C: Elevated blood pressure

D: Decreased respiratory rate

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ANSWERS

B: Pale, clammy skin

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QUESTIONS

2:  Altered mental status that often accompanies diabetic emergencies is often mistaken for:A: a migraine.

B: alcohol intoxication.

C: a severed spinal cord.

D: a swollen or deformed lower extremity.

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ANSWER

B: alcohol intoxication.

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QUESTIONS

3:  Diabetes is considered a disease of balance because the patient must try to balance:A: food intake with glucose therapy.

B: medication with charcoal intake.

C: medication to stimulate the liver with fat intake.

D: the need for glucose with the available insulin supply.

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ANSWER

A: food intake with glucose therapy.

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QUESTIONS

4:  Which of the following conditions can occur if an unconscious patient is given oral glucose?A: Shock

B: Aspiration

C: Hypotension

D: Hyperglycemia

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ANSWER

B: Aspiration

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QUESTIONS

5:  Diabetes is caused by the body's lack of adequate amounts of:A: sugar.

B: insulin.

C: glucose.

D: aspartame.

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ANSWER

B: insulin.

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QUESTIONS

6:  The form of diabetes that develops as a person ages is called:A: type I diabetes.

B: type II diabetes.

C: type III diabetes.

D: adult sugar disorder.

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ANSWER

B: type II diabetes.

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QUESTIONS

7:  Which of the following will probably NOT cause a diabetic emergency in a patient with a history of diabetes controlled by medication? A: Eating a regularly scheduled meal

B: Unusual exercise or fatigue

C: Overeating

D: Infection

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ANSWER

A: Eating a regularly scheduled meal

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QUESTIONS

8:  Oral glucose should be placed:A: on the tongue of a conscious patient.

B: on the tongue of an unconscious patient.

C: between the cheek and gum of a conscious patient.

D: between the cheek and gum of an unconscious patient.

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ANSWER

C: between the cheek and gum of a conscious patient.

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QUESTIONS

9:  The term "polyuria" can be defined as frequent: A: seizure activity.

B: bouts of depression.

C: Urinating excessively.

D: drinking to satisfy continuous thirst.

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ANSWER

C: Urinating excessively.

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QUESTIONS

10:  What waste products are formed when fat is used for energy? A: Pancreatic acids

B: Glucose and carbon dioxide

C: Glucose and fatty acids

D: Ketones and fatty acids

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ANSWER

D: Ketones and fatty acids