Acute diabetes complications

Question 1

multi dose insulin users testing rate

Answer 1

at least 3 times daily

Question 2

Once a day insulin users testing rate

Answer 2

once per day at variable times

Question 3

at target T2DM testing rates

Answer 3

unless on sulfs, no need to check daily, checking A1C every 3-6 months is good.

Question 4

above target T2DM testing rates

Answer 4

Daily testing could provide some help in controlling A1C levels

Question 5

Exercise and BG

Answer 5

Do not start to work out if you are <4 or >14
- levels during can fluctuate from different workouts, have snacks close (may need 15g of carbs every 30min)
-24 hours after can fluctuate with delayed hypo in 6-12 hours (monitor closely after)\

Question 6

dose change for cart golfing, gardening, shopping

Answer 6

Low level
decrease bolus 25-50%

Question 7

Dose change for mowing, biking, leaves, swimming

Answer 7

moderate level
decrease bolus by 50-75%

Question 8

dose change needed for competitive sports, snow shovelling, jogging, soccer

Answer 8

high level
decrease bolus by 75-100%

Question 9

Alcohol and diabetes

Answer 9

-hypoglycemia can look like drunkenness
-high carb drinks
-delayed hypo 24 hours later from any alcohol (risk of night time lows, snack before bed and test)

Question 10

Alcohol effect

Answer 10

causes reduced hepatic glucose production causing delayed hypoglycaemia

Question 11

Travelling east

Answer 11

Day is shorter so you need to decrease the basal dose (3h 1/4-1/3) (7h 1/3-1/2)
get onto dosing schedule at location sooner

Question 12

Travelling west

Answer 12

day is longer so you need to plan for an extra dose at landing or lay over with a snack

Question 13

driving diabetes

Answer 13

check before driving if <4 then 15g of carbs, once >5 wait 40 min for brain to work and drive
- have candy close at hand in the car
-diabetes medical every 2 years

Question 14

Blood sugars during sick days

Answer 14

Body releasing cortisol, glucagon and hormones, increases liver glucose and promotes insulin resistance
- You might need more insulin and your BG may increase without eating
-check >4 times daily
-increase hydration
-avoid decongestants

Question 15

Ketoacidosis Sx

Answer 15

increased RR
dehydration
ketones on breath and in urine
abdominal pain
decreases consciousness

Question 16

hyperosmolar hyperglycemic state

Answer 16

Occurs days to weeks after severe illness trigger
- BG >25 with little to no ketones
-needs hospital if Sx appear

Question 17

hyperosmolar hyperglycemic state Sx

Answer 17

If 2 or more appear go to hospital
- vomiting, diarrhea (no fluids)
- gastroenteritis with fever
- abdominal pain
-BG >14 and climbing
-ketones in urine or blood