part 11

Question 1

Why might hypoglycemia become critically low with no warning signs?
aka hypoglycemia unawareness

Answer 1

related to autonomic neuropathy and lack of counterregulatory hormones
-pt’s at risk for this should keep blood glucose levels somewhat higher

Question 2

What are some causes of regular hypoglycemia?

Answer 2

• too much insulin or hypoglycemic agents
• too little food
• delayed eating time
• too much exercise
• high glucose falls too rapidly

Question 3

Explain the rule of 15 for a pt with hypoglycemia?

Answer 3

• consume 15g of simple CHO (4 to 6oz fruit juice)
• recheck glucose in 15 minutes (repeat if <70 again)
• avoid foods with fat (decreases absorption of sugar)
• give complex CHO after recovery

Question 4

How can you treat hypoglycemia if a pt is not alert enough to swallow?

Answer 4

• 50% dextrose 20 to 50 mL IV push

- glucagon 1 mg IM or subcutaneous

Question 5

What is one of the leading causes of diabetes related deaths?

Answer 5

angiopathy: cardiovascular disease and stroke

- can be micro/macrovascular

Question 6

What are the 2 types of angiopathy?

Answer 6

macrovascular

microvascular

Question 7

Disease of the large and medium-sized blood vessels.

Answer 7

macrovascular angiopathy

Question 8

What are 3 types of macrovascular angiopathy?

Answer 8

cerebrovascular disease
cardiovascular disease
peripheral vascular disease

Question 9

What are the risk factors associated with macrovascular complications?

Answer 9

obesity
smoking
hypertension
high fat intake 
sedentary lifestyle 
screen and treat hyperlipidemia

Question 10

Who is at risk for hypoglycemia unawareness?

Answer 10

• pt with repeated hypoglycemia
• older pt’s
• pt’s taking B-adrenergic blockers (beta blockers)