Endo- diabetic emergencies

Question 1

hypoglycaemia

Answer 1

abnormally low blood glucose level, typically under 4mmol/l

Question 2

what is the most common side effect of insulin therapy

Answer 2

hypoglycaemia

Question 3

precipitating factors to hypoglycaemia episodes

Answer 3

irregular eating habits
alcohol excess
unusal exertion
more insulin injected than needed

Question 4

times of greatest risk of hypoglycaemia

Answer 4

before meals
during the night
during or after exercise

Question 5

mild hypo management

Answer 5

consumption of 15-20g fast acting carbohydrate such as glucose tablets, small can of non-diet soda, sweets, or fruit juice

Question 6

is chocolate useful for hypo management

Answer 6

no- slower absorption

Question 7

what should you consume after a hypo

Answer 7

slow acting carbs eg toast

Question 8

severe hypo management

Answer 8

200ml 10% dextrose IV
- if no IV access, 1mg glucagon IM

Question 9

increased insulin demand (5 Is)

Answer 9

infection- UTIs, pneumonia, cellulitis
inflammation- pancreatitis, cholecystitis
intoxication- alcohol, cocaine, methanol
infarction- acute MI, stroke
iatrogenic- surgery, steroids

Question 10

what can excessive accumulation of ketone bodies lead to

Answer 10

acidosis

Question 11

osmotic related clinical features of diabetic ketoacidosis

Answer 11

thirst and polyuria
dehydration

Question 12

ketone body related clinical features of diabetic ketoacidosis

Answer 12

flushed
vomiting
abdominal pain and tenderness
> respiratory rate
distinctive smell on breath

Question 13

diabetic ketoacidosis associated conditions

Answer 13

sepsis
gastroenteritis

Question 14

complication of diabetic ketoacidosis which mostly happens in children/YAs

Answer 14

cerebral oedema

Question 15

initial management in diabetic ketoacidosis

Answer 15

replace fluid losses- sodium chloride
and potassium
insulin replacement

Question 16

diabetic ketoacidosis insulin replacement rate

Answer 16

0.1units/kg per hour