Diabetic Emergencies Flashcards
Diabetes Mellitus
A metabolic disorder in which the body cannot metabolize glucose.
Consists of 3 groups:
Pre-diabetes:
— Elevated blood sugar is levels
— Not high enough for Type II Diabetes
— Likely to advance in 10 years
Type II Diabetes:
— Chronic condition that affects Insulin
— Body does not produce enough Insulin
— Body resists naturally occurring Insulin
Type I Diabetes:
— Genetic and chronic condition
— Pancreas produces little or no insulin
— It typically appears in adolescence
Insulin
Produced by the Pancreas; Insulin allows sugar (glucose) to pass from the blood stream into the cellular walls of cells.
Production of Insulin is stimulated by the increase in blood sugar levels (mg/dL).
Glucose
(mg/dL)
A simple sugar which is an important energy source in living organisms, and is a component of many carbohydrates.
As important to the body and cells as oxygen is to the brain.
Stages of Glucose Levels:
Hypoglycemic levels:
— Insulin Shock
— Lower than 70 mg/dL (5.6 mmol/L )
Normal glucose levels:
— 80-120 mg/dL (5.6 mmol/L )
Hyperglycemic levels:
— Diabetes Ketoacidosis (DKA)
— Greater than 200 mg/dL (7 mmol/L )
— Ketonic Breath
Type I Diabetes
(Insulin Dependent)
(IDDM)
A chronic condition in which the pancreas produces little or no insulin.
It typically appears in adolescence, and is primarily caused by either infection/disease or due to heredity and/or genetics.
Often considered to be more severe than Type II Diabetes.
NOTE: Patient may become agitated or confused when glucose levels increase!
Assessment Findings:
— Blurred vision / Headaches — Excessive urination / Odor — Diaphoresis — Abdominal bruising (from shots) — Tachycardia / Fatigue
Treatments:
— Physician prescribed Insulin shots (daily) — Request ALS backup (as needed) — Oral Glucose — Supplemental O2 (as needed) — Transport patient in position of comfort
Type II Diabetes
(Non-Insulin Dependent)
(NIDDM)
A chronic condition that affects the way the body processes blood sugar (glucose).
With Type II Diabetes, the body either does not produce enough insulin, or it resists insulin entirely.
NOTE: Patient become agitated or confused when glucose levels increase!
Assessment Findings:
— Blurred vision / Headaches — Frequent urination / thirst — Numbness in hands / feet — Poor wound healing — Unintended weight loss — Discolored pigmentation in skin
Treatments:
— Request ALS backup (as needed)
— Oral Glucose
— Supplemental O2 (as needed)
— Dietary / Life-style counseling
— Transport patient in position of comfort
Diabetic Ketoacidosis
(DKA)
Decreased Insulin which results in an increase in blood sugar.
A serious diabetes complication where the body produces excess blood acids (Ketones).
This condition occurs when there isn’t enough insulin in the body, and can be triggered by infection or other illness.
NOTE: Patient become agitated or confused when glucose levels increase!
Assessment Findings:
— Low / Normal Blood Pressure — Acetone Breath (fruity odor) — Polyuria (excessive urination) — Polydipsia (excessive thirst) — Polyphagia (excessive hunger) — Warm / Dry Skin — Altered mental status / Low GCS — Abdominal pain — Tachycardia — Kussmaul Breathing
Treatments:
— Request ALS backup (as needed) — Oral Glucose — Supplemental O2 (as needed) — Dietary / Life-style counseling — Transport patient in position of comfort
Hypoglycemia
(Insulin Shock)
Low blood sugar; the body’s main energy source.
Diabetes treatment and other conditions can cause Hypoglycemia.
NOTE: Do not place adjuncts in patient’s mouth if they cannot maintain an airway.
Assessment Findings:
— Altered LOC (Level of Consciousness) — Combative — Pallor / Cool / Diaphoresis — Tachycardia — Tachypnea — Seizures — Normal Blood Pressure (typically) — Stroke-like symptoms — Rapid onset
Treatments:
— Request ALS backup (as needed) — Oral Glucose — Supplemental O2 (as needed) — Cardiac monitoring (12-Lead) — Hospitalized fluid replacement — Dietary / Life-style counseling — Transport patient in position of perfusion
Hyperglycemia
High blood sugar; this condition can often have causes that are not due to underlying disease.
Examples include recent consumption of a high carbohydrate meal or medication side effects.
NOTE: Do not place adjuncts in patient’s mouth if they cannot maintain an airway.
Assessment Findings:
— Low / Normal Blood Pressure — Acetone Breath (fruity odor) — Polyuria (excessive urination) — Polydipsia (excessive thirst) — Polyphagia (excessive hunger) — Warm / Dry Skin — Altered mental status / Low GCS — Abdominal pain — Tachycardia — Kussmaul Breathing
Treatments:
— Request ALS backup (as needed) — Oral Glucose — Supplemental O2 (as needed) — Dietary / Life-style counseling — Transport patient in position of comfort
Diabetic Coma
(Hypoglycemia)
A coma condition which derives from the rapid onset of severe Insulin Shock or severe Hypoglycemia.
Increased Insulin leads causes the body to shunt it’s blood sugars, which results in extremely low blood sugar levels.
A true medical emergency which mimics dehydration.
