Diabetes Complications

1
Diabetes Complications

• When to Call for Help

2
Outline

• Blood Sugars
• Normal
• Acceptable
• Hypoglycemia
• Mild, Moderate, Severe
• Prevention and Treatment
• Hyperglycemia
• Annoying, Serious, DKA
• Prevention and Treatment

3
Blood Sugars

• Normal Blood Sugars
• 70-110 mg/dl
• Acceptable Blood Sugars (in the setting of
  diabetes)
• Depends on maturity, age, family
• Infants 100-200
• Younger kids 80-180
• Older kids 70-120

4
Treatment Programs

• Type I Diabetes
• Individualized Insulin Strategy
• Type II Diabetes
• Diet and Exercise
• Oral Medications
• Individualized Insulin Strategy

5
Normal Physiology
Insulin
0
Time
6
Common Types of Insulin
Lispro
Regular
NPH
Lente
Ultralente
Glargine
7
Multiple daily injections
Insulin
Time
8
Mixed split program
Insulin
Time
9
Pump
Insulin
0
Time
10
Hypoglycemia

• Normal Blood Sugars
• 70-110 mg/dl
• Low Blood Sugars Anything less than the
  goal.

11
Hypoglycemia

• Symptoms (Mild)
• Shaky
• Sweaty
• Hungry
• Nauseated
• Headache
• Dizzy
• Feel funny

12
Hypoglycemia

• Counter Regulatory Hormones
• Counteract the effects of insulin
• Increase the blood sugar levels

13
Hypoglycemia

• Counter Regulatory Hormones
• Cortisol
• Adrenalin
• Growth Hormone
• Glucagon

14
Hypoglycemia

• Counter Regulatory Hormones
• Induces the symptoms of hypoglycemia

15
Hypoglycemia

• Severe
• Unconscious
• Seizure

• Moderate Symptoms
• Uncooperative
• Combative
• Lethargic

Problem
Bigger Problem
16
Prevention of Hypoglycemia

• Feed snacks before activities.
• Follow the meal plan.
• Make sure that the correct amount of insulin is
  given.

17
Hypoglycemia

• Treatment
• Eat or Drink
• Glucose Gel call 911
• Glucagon Shot call 911

18
Hyperglycemia

• Normal Blood Sugars
• 70-110 mg/dl
• Acceptable
• Depends on the age
• Only half of the blood sugars are expected to be
  in the acceptable range

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Hyperglycemia

• Signs of hyperglycemia
• Polyuria
• Nausea
• Weakness
• Abdominal Pain
• Back Pain
• Lethargy
• Kussmaul Breathing

Problem
Annoying
Big Problem
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Hyperglycemia

• Prevention
• Follow insulin and diet plan
• Treatment
• Insulin
• Fluids

21

• Pumps

22
Pumps

• Pump Malfunction
• Catheter Malfunction

Problem
23

• Hypoglycemia
• Prevention
• Eat the meals and snacks
• Feed a snack before activities
• Treat
• Eat
• Glucose Gel
• Glucagon shot
• Hyperglycemia
• Prevention No unauthorized snacks
• Treat Give more Insulin

24
Last Talk of the Morning

• Cant absorb any more information
• Backside is falling asleep
• Time for lunch and I am still talking

Big Problem
Problem
Biggest Problem Yet !!!
25
Prevent Hypoglycemia Go and Eat