Diabetes Flashcards
What blood glucose level is hypoglycaemia?
<4mmol/L
Define the clinical classification of severe hypoglycaemia
Needs parenteral therapy
Coma/seizure
Define mild hypoglycaemia
Symptomatic glycaemia that resolves with self treatment
Define biochemical hypoglycaemia
Plasma glucose <4.0 with no symptoms
How do you treat mild hypoglycaemia in a patient who is awake and talking?
Give dextrosol tablets
Avoid fruit juice in patients with renal disease
How do you treat moderate hypoglycaemia in a patient who is semi-conscious and able to swallow?
Give 1.5 to 2 tubes of glucose gel
If this is ineffective - give 1mg of glucagon IM
How do you treat severe hypoglycaemia in the unconscious patient?
GET SENIOR HELP
Stop any IV insulin
If IV access available - give 75ml 20% glucose or 150ml of 10% glucose
If no IV access - 1mg of glucagon
How should you assess someone after they have recovered from a hypoglycaemic episode?
Ask when patient last ate
Check dosage of insulin including time given at
Check for signs of lipohypertrophy
Check credibility of blood glucose monitoring
What are the driving rules for being diabetic?
Check glucose prior to driving and every 2hrs
Keep a source of glucose and meter in the vehicle
Do not drive if glucose <5mmol/L
Define diabetic ketoacidosis
A disordered metabolic state that usually occurs in the context of an absolute or relative insulin deficiency accompanied by an increase in the counter-regulatory hormones i.e. glucagon, adrenaline, cortisoleand growth hormone
What does hyperglycaemia lead to?
Glycosuria
Electrolyte loss
Dehydration
Reduced renal function
How does ketoacidosis occur?
Insulin deficiency -> stress hormone activation -> increased lipolysis -> incrased FFA to liver -> ketoacidosis and increased lactate
Define ketonaemia
> 3mmol/L
Define ketonuria
> 2+ on a dipstick
Define hyperglycaemia
> 11.0mmol/L
