Acute Complx Flashcards
what are the 3 acute complx?
1) hyperglycemia
2) DKA (diabetic ketoacidosis)
3) HHS (hyperosmolar hyperglycemic state)
what range is your BG if you are hypoglycemia?
<4mmol/L
where is hypoglycemia more frequently seen?
in type 1 pts d/t insulin injections (PO insulin not used because it will be broken down by stomach enzymes due to it being a hormone and protein)
hypoglycemia occurs if?
- pt receives too much insulin
- pt doesn’t eat enough (lack of CHO in diet)
- pr overexerts themselves (body uses glucose as fuel during exercise, which can deplete these stores)
Hypoglycemia: what relies on glucose for energy?
neurons
Hypoglycemia: T or F: neurons require insulin.
false; glucose automatically moves into RBCs and neurons without additional help)
Hypoglycemia: what happens if adequate glucose is not supplied to neurons?
cerebral fx and activation of ANS is altered –> coma
what is the Tx for hypoglycemia?
15g (20g if more severe) of CHO PO (eg. fruit juice, candy, chocolate)
hypoglycemic coma
Loss of consciousness d/t inadequate glucose supply to neurons
what is the Tx for hypoglycemic coma?
- Glucagon breaks down glycogen and releases glucose
- -> Administer 1mg glucagon SC or IM
- -> 20-50mL 50% glucose IV (eg. 50 g glucose in 100mL of water)
DKA
byproduct of lipid metabolism is ketones
why is DKA usually seen in Type 1 DM?
body isn’t producing enough insulin, which usually helps glucose enter cells to be used as fuel, body breaks down FA
what are the 3 requirements for DKA?
- must be hyperglycemia
- requires ketosis (formation/appearance of ketones)
- metabolic acidosis (fixed acid)
where is HHS usually seen?
in Type 2 DM and elderly
T or F: HHS only occurs in Type 2 DM
no; can occur from other causes (ie, infection)
HHS
A state of elevated blood glucose (hyperglycemia), and a high concentration of glucose (hyperosmolar)
what is HHS caused by?
- excessive CHO intake
- increased IR:
1) presence of insulin
2) hyperglycemia
3) lack of a hypoglycemic
response
what else happens in HHS?
hyperosmolarity and dehydration
remember, ketoacidosis in HHS does …
NOT occur because insulin is present in Type 2 DM. this means that lipolysis does not occur, so there is no excess of ketones
severe hypoglycemia in HHS leads to…
1) hyperosmolarity
2) cellular efflux (glucose flows out of blood and into filtrate causing increased OP in the filtrate, pulling in
more fluid)
3) polyuria and glucosuria\
4) fluid loss
5) dehydration
