Other Medical Flashcards
What are the roles of the pancreas?
Regulating blood glucose
Secreting digestive enzymes to break down fats and carbohydrates
What is glucagon?
Secreted by alpha cells in the islets of langerhans
Secreted in response to a low bgl
Causes glycogenolysis and glucoenogenesis
leads to an increase in bgl
What is insulin?
Secreted by beta cells of the islets of langerhans
Secreted in response to high bgl
Allows cells to uptake and utilise glucose
Causes glycogenesis
Inhibits release of glucagon
Results in a lowered bgl
What is the pathophysiology of diabetes?
An inadequate amount of insulin is produced
Cells cannot uptake glucose
Cells starved of energy
Inadequate insulin so high glucagon
Higher glucose due to glycogenolysis
Fats broken down as energy source for cells
What is the pathophysiology of hyperglycaemia?
Increased circulating blood glucose causes fluid to move from cells and surrounding tissue into the blood.
Why do patients with hyperglycaemia urinate more often?
To get rid of excess fluid (blood volume) that has been caused by increased osmolarity of the blood.
This causes dehydration and electrolyte imbalances.
What are the signs and symptoms of hyperglycaemia?
Poor perfusion - (increased CRT, tachycardia, hypotension) Lethargy Altered LOC Vomiting Severe abdo pain Deep rapid breathing Fruity breath
What are the three P’s of diabetes?
Polyphagia - increased eating
Polyurea - increased urination
Polydipsia - Increased thirst
How do we manage hyperglycaemia?
Call back up for patients who are hyperglycaemic and symptomatic.
Back up may consider fluid resuscitation if the patient is in severe shock.
Transport
What is hypoglycaemia?
Caused when there is too much insulin for the amount of glucose the patient has had.
Why do hypoglycaemics have an altered level of consciousness?
Because the brain is not receiving enough glucose to carry out normal cellular function.
What are the signs and symptoms of hypoglycaemia?
Altered LOC - confused, appear intoxicated, aggressive, unresponsive Pale Sweaty Tachycardic Rapid onset of symptoms
How do we manage hypoglycaemia?
Manage airway appropriate to the patient’s level of consciousness.
Requires management if BGL is less than 3.5mmol and they are symptomatic.
If conscious and able to swallow, give oral glucose.
If unable to administer oral glucose give IM glucagon (although IV glucose is preferred if someone qualified is present).
When their level of consciousness improves give them complex carbs
What is a normal blood glucose?
Maintained between 4-8 mmol/L
