CH. 4 Diabetes

Question 1

What is diabetes?

Answer 1

Diabetes is a complex disease of sugar metabolism characterized by a broad array of psychological disturbances.

Question 2

What is the normal blood sugar range?

Answer 2

80-120 mg/dL

Question 3

What is hypERglycemia?

Answer 3

too much sugar in the blood, not enough insulin

Question 4

Signs and symptoms of hypERglycemia

Answer 4

LOR: restless, Drunken 
HR: weak and rapid 
RR: Increased 
SCTM: warm, pink, dry 
Increased hunger, increased thirst, increased urination and fatigue
Breathe odor - acetone and sweet 
Persistent high blood sugar levels

Question 5

Treatment principles for HypERglycemia

Answer 5

1. check the patients blood sugar
2. if you are unable to distinguish between between Hyper and Hypo - glycemia, GIVE SUGAR
3. hydrate
4. evacuate. WFR is not allowed to adjust insulin levels. only the patient can do that.

Question 6

What is HyPOglycemia?

Answer 6

Not enough sugar in blood. Too much insulin.
hypoglycemia is a complication of diabetes caused what the insulin dependent diabetic patient takes too much insulin or fails to eat sufficient sugar to match the insulin level

Question 7

Signs and symptoms of HyPOglycemia

Answer 7

1. LOR weak, disoriented, irritable, not quite themselves. Progressing to obvious mental status changes, unresponsive and seizures.
2. HR rapid
3. RR normal or shallow
4. SCTM pale, cool, clammy
5. BB no changes or slightly elevated
6. no change in breath odor
7. sugar level is less than 80 mg/dL

Question 8

Treatment principles of Diabetes

Answer 8

1. check the patients blood sugar
2. if unable to distinguish between HYPO and HYPER - glycemia GIVE SUGAR
3. GIVE SUGAR until patient is adequate LOR. If unresponsive, turn on side and rub sugar on gums
4. once the patient responds to sugar, a more hardy snack or meal might be appropriate. monitor blood sugar.
5. rapid evac any diabetic patient with hypoglycemia who doesnt respond to treatment

Question 9

Prevention of having an insulin dependent diabetic emergency on expedition

Answer 9

1. interview participant - They should have it under control,
   - no medical emergencies in over a year.
   - They should have experience managing their diabetes while exercising.
2. ask participant to bring 2x the supplies they would normally need for the time period.
3. ensure they are eating and staying hydrated. Ask them to keep a record of their blood sugar levels in case you need to reference them in an emergency
4. verify they have a “sick day” plan

Question 10

Evacuation guidelines for diabetic emergency

Answer 10

1. rapid evac any patient with hypoglycemia unresponsive to treatment
2. rapid evac any patient with Hyperglycemia that cannot be managed with persistent persist vomiting or diarrhea. Ketones in urine, persistent high blood sugar levels. signs and symptoms of dehydration or altered mental status
3. diabetic patients with occasional manageable hyper or hypo-glycemia can stay in the field.