Kussmaul respirations (increased rate & depth of respiration)
Nausea and vomiting
Lethargy
Warm, dry skin
Hint: Warm and dry, sugar's high
Management:
Carbohydrate-controlled diet
Insulin & oral antidiabetic agents (Type 1 diabetes requires insulin; Type 2 can use oral agents)
Goal: HGB A1C level under 7%
Somogyi Phenomenon:
Morning hyperglycemia due to overnight hypoglycemia
Prevention: Consume a snack with nightly insulin dose
Hypoglycemia
Definition: Blood glucose level under 70 mg/dL
Causes:
Excess insulin
Decreased food intake
Exercise
Excess alcohol
Signs & Symptoms:
Hunger
Irritability
Confusion
Diaphoresis (sweating)
Headache
Shakiness
Blurred vision
Pale, cold, clammy skin
Hint: Cold and clammy, need some candy
Severe Symptoms:
Seizure
Coma
Management:
If conscious, consume 15 grams of a readily absorbed carbohydrate (e.g., 4 oz juice/soda, 8 oz milk)
Recheck blood glucose after 15 minutes
If still under 70 mg/dL, consume another 15 grams of carbohydrate and recheck after 15 minutes
Once glucose > 70 mg/dL, consume a snack with protein and carbohydrate (e.g., cheese and crackers)
Hint: 15-15 rule (15 grams of carbohydrate, wait 15 minutes)
Quiz Questions
Q: Is diaphoresis and shakiness indicative of hyperglycemia or hypoglycemia?
A: Hypoglycemia
Q: The goal when treating diabetes is to maintain an HGB A1C level under ___ percent?
A: 7%
Q: What do you call morning hyperglycemia due to overnight hypoglycemia?
A: Somogyi phenomenon
Q: An individual with hypoglycemia should consume ___ grams of a readily absorbed carbohydrate and recheck their blood sugar in ___ minutes?
A: 15 grams, 15 minutes