Diabetic Complications Flashcards
If episode of hypoglycemia occurs in diabetic patient,
ingest 15 gm carbohydrate and recheck glucose levels in 15 minutes
most common cause of hypoglycemia in non diabetic patients
drugs
whipple’s triad
- sx of hypoglycemia present. 2. plasma glucose conc low when sx are present. 3. sx relieved by administration of glucose
tx for non diabetic hypoglycemia
dietary therapy, glucose therapy
Lab findings for DKA
increased glucose, BUN, creatinine, phosphate, potassium, WBC, plasma osmolality, amylase, lipase, lipids. Decreased sodium and bicarbonate, pCO2. Increased anion gap. Ketonuria and serum ketones
Higher mortality rates in DKA or HHS
HHS (hyperosmolar hyperglycemic state)
Lab findings in HHS
very high levels of glucose, BUN/creatinine, and plasma osmolality. potassium levels often normal
Tx of DKA and HHS
Fluid, insulin, and electrolyte management
target glucose levels in DKA and HHS
For DKA, less than 200 mg/dL. And for HHS, 250-300 mg/dL
Patient with DKA. Give fluid and insulin. Know their blood glucose is 180 mg/dL. Next step?
Change IVF to dextrose containing solution. IV insulin continued until serum anion gap is below 12 meq/L, serum bicarbonate above or equal to 18 meq/L, and venous pH is above 7.3
electrolyte management in DKA and HHS
potassium replacement when levels less than 5.3 meq/L. phosphate replacement when levels less than 1 mg/dL
complications of DKA and HHS
electrolyte abnormalities, cerebral edema, and non cardiogenic pulmonary edema
Most common complication of diabetes mellitus
diabetic neuropathy
most common peripheral mononeuropathy
medial nerve palsy
Mononeuropathy multiplex
multiple mononeuropathies in same patient. results in asymmetric polyneuropathy
