Diabetic emergencies

Question 1

what is the main function of insulin

Answer 1

• promote transport of glucose from blood into skeletal and adipose tissue (into cells)

Question 2

why is it important for glucose to move out of the blood stream and into cells

Answer 2

• main source of energy for cells
• if it stays in blood stream can have huge issues

Question 3

where does insulin come from

Answer 3

• pancreas

Question 4

how does the pancreas control blood glucose levels?

Answer 4

• with 2 hormones insulin (comes from beta cells) and glucagon (comes from alpha cells)

Question 5

what is basal levels of insulin from pancreas

Answer 5

• small levels of insulin released throughout the day

Question 6

what is type I DM

Answer 6

• breaks down pancreatic beta cells (insulin)
• is insulin dependent
• is prone to ketoacidosis when glucose levels get too high.

Question 6

bolus insulin released from pancreas

Answer 6

• when we eat food pancreas releases a big amount of insulin

Question 7

what is type II DM

Answer 7

• insulin receptors on tissues become resistant to insulin
• decreased ability for beta cells to create insulin
• glucagon is released stimulating more glucose form liver

Question 8

hypoglycemia

Answer 8

• blood sugars below 4.0
• 4.0-3.0 patients should eat carbs to increase
• less than 3.0 immediate action

Question 9

risk factors for hypoglycemia

Answer 9

• missed/delayed meals
• low carbs
• exercise
• med errors (wrong insulin dose)
• acute illness
• dementia

Question 10

what are the neurogenic autonomic symptoms of hypoglycemia

Answer 10

• tremors
• palpitations
• anxiety
• sweating
• hunger
• numbness/tingling

Question 11

neuroglycopenic symptoms

Answer 11

• dizziness
• weakness
• drowsiness
• delirium
• confusion
• seizures
• coma
  -difficulty concetrating

Question 12

how to treat hypoglycemia

Answer 12

• depends on patient level of consciousness
• dietary or parenteral carbs or administer glucagon (severe cases)

Question 13

when do you give glucagon and IV 50% dextrose to a hypoglycemic patient

Answer 13

• IV 50% dextrose right away if IV is open
• if Iv cannot be put in then glucagon is the fastest choice then start IV

Question 14

what is diabetic ketoacidosis

Answer 14

• acute
• most common with type I
• body breaks down lipids for fuel
• ketones in urine

Question 15

hyperglycemia with DKA is due to:

Answer 15

• increased gluconeogenesis (produce glucose and lactic acid)
• increased glycogenolysis (forms glucose)
• decreased glucose utilization by cells
• ketosis (fat metabolism)
• metabolic acidosis
• dehydration (at risk for hypovolemic shock)
• ketonuria and electrolyte imbalances

Question 16

risk factors for DKA

Answer 16

• type I
• acute and severe illness/stress
• infection
• inadequate insulin dosages

Question 17

signs and symptoms of DKA

Answer 17

• abd pain
• breath odor
• dry mouth
• fever/flushed dry skin
• ketones in urine
• restless/confusion
• laboured breathing
• rapid/weak pulse
• hypotension
• glucose greater than 14
• thirsty/increased urine

Question 18

treat DKA

Answer 18

• infusion of isotonic saline (stabilize CO, increasing PL, an dperfusion to tissues) - add dextrose once sugars are down to 11
• 40 of KCl for correct hypokalemia
• administer insulin (regular or rapid acting

Question 19

how do we determine the dose of insulin IV to give?

Answer 19

• give low dose if serum potassium is greater or equal to 3.3 - don’t want to drop it more