Hyper and Hypoglycaemia Flashcards
list 6 symptoms of diabetes
Thirst Frequent urination especially at night Tiredness Sudden change in weight: weight loss Genital itching and frequent thrush Blurred vision
in which 2 ways can diabetes be diagnosed
Blood glucose level
Oral glucose tolerance test
what value is classed as high after doing a Oral glucose tolerance test and how is it done
anything above 11.1 mmol for someone with diabetes
anything below 11.1 mmol if a patient doesn’t have diabetes
always performed 8-12 hours after fasting. Px will then drink a high concentration of glucose solution and the blood is then tested 2 hours later
name the 4 types of diabetes
Impaired glucose tolerance
Gestational diabetes
Type 1 diabetes mellitus
Type 2 diabetes mellitus
what can Impaired glucose tolerance result in
higher rate of cardiovascular death
Might develop diabetes mellitus
when does Gestational diabetes usually develop and what causes the diabetes
Develops during or after pregnancy
Pregnancy hormones can block insulin
which 2 ways can you improve diabetes control
Diet and exercise
Type 1 diabetes: life depends on insulin injections
Type 2 diabetes: add tablets to diet and exercise regime. If
necessary add insulin injection
Manage BP and blood lipids appropriately
name 2 acute complications of diabetes
Hypoglycaemia and Hyperglycaemia
list 4 chronic Microvascular complications
Retinopathy (eye)
Nephropathy (kidney disease)
Neuropathy (small nerve disease)
Autonomic neuropathy (peripheral nerves) - damage to nerves that regulate bp, heart rate, bladder emptying, digestion
name 3 chronic macrovascular complications
Coronary artery disease
strokes
amputations
where is insulin made from and what is the purpose of it
the pancreas
insulin is needed to transport glucose (a simple sugar from our diet) to the cells of our body
Insulin transports glucose from blood into cells
what is hyperglycaemia and what value is it classified as
Too much glucose in the bloodstream
Occurs when blood glucose levels are not strictly controlled
Blood glucose level of 10+ mmol/l
what is a normal value of blood glucose
Normal 4 to 6 mmol/l
when do the symptoms of hyperglycaemia usually become noticeable
until there is a blood glucose level of 15-20+ mmol/l
what is ketoacidosis and how can it be dangerous
Not enough insulin to move glucose into cells: fat is used as a fuel source = high levels of ketones
Breakdown of fats: ketones build up in the blood and urine (poisonous)
what should be done if you suspect a person has ketoacidosis
Urine test should be performed every 4-6 hours anytime a person with DM is: Registering blood sugar above 12mmol/l Sick Unusually thirsty or has a dry mouth Urinating frequently Vomited
name 5 signs/symptoms a person may have if they are suffering from ketoacidosis
Registering blood sugar above 12mmol/l Sick Unusually thirsty or has a dry mouth Urinating frequently Vomited
name 6 warning signs that ketoacidosis is getting serious
Flushed face Dry skin and mouth Nausea or vomiting Stomach pain Deep, rapid breathing Fruity breath odour
send this person to A&E - if untreated, can lead to a coma or death
what blood sugar level is classed as hypoglycaemic
BGLs <4 mmol/L
what is released as a warning sign of hypo and what is the end result of a hypo attack
ADRENALIN is released and it is responsible for the warning signs of a hypo
End-result of a hypo: brain does not get enough sugar, so it cannot function, the patient could die
list 5 causes of hypoglycaemia
Too much insulin / too many tablets Delayed or missed meals or snacks Not enough food (especially carbohydrate) Unplanned or strenuous exercise Drinking alcohol without food No obvious cause
list the 9 diabetes medications that can cause a higher risk of hypoglycaemia
Insulin Sulphonylureas Glipizide Gliclazide Chlorpopamide Gliquidone Glimerpiride Tolbutamide Repaglinide
name a medication that is unlikely to cause a hypo
metformin
what should people who are on arcarbose always be given and why
always be given sg like Lucosade as the absorption (release?) of glucose is very slow
what 2 types of medications used to treat other conditions risk modifying the action of tablets for diabetes
antibiotics
anti depressants
which type of diabetic patient is hypo more common in and why
type 1 DM
The better the diabetes control the more common the hypo is
Requires careful balance between insulin – food - exercise
hence have to calculate exact intake of food esp carbs and amount of insulin injected
list 5 types of mild hypo symptoms that are treatable
Hungry
Trembling and sweating
Irritable, aggressive, unreasonable
Pale, fast pulse, tingling of the limps
Blurring vision
how must you treat a mild hypo
Immediate: quick carbohydrate: fruit juice, coke, glucose tablets,
sugar, chocolate
Long acting: sandwich, biscuits, cereal, fruit
list 4 signs of a severe hypo
Difficulty in concentrating
Confused and vague
Irritable and irrational
Loss of consciousness, fits and coma
what is the treatment of severe hypo if someone is conscious
Hypostop (sugar gel), honey, treacle or jam (2-3 teaspoons) inside the mouth, once the px is better, follow up as per mild hypo
if a person is suffering from hypo and is unconscious - how are they treated
if you are trained use Hypostop etc; if not, place the px in the recovery position and GET HELP!
Glucagon or iv glucose should only be given by trained
personnel
