Ch. 18-Diabetic Emergencies

1. Ch. 18-Diabetic Emergencies 1

2. 18.1 Diabetes • Type I diabetes, or insulin-dependent diabetes (IDDM), in which the victim has little or no ability to produce insulin. Type I usually begins in childhood (previously referred to as “juvenile-onset”), and victims require daily insulin injections. • Type II diabetes, or non-insulin dependent diabetes mellitus (NIDDM), previously called “adult-onset diabetes,” in which the victim produces insulin but either not enough insulin or the cells do not respond to it. Type II diabetes is generally controlled by diet, exercise, and/or oral medication. 2

3. PROGRESS CHECK 1. Insulin is needed to move __________ out of the bloodstream. (oxygen/glucose/carbon dioxide) 2. Cells need glucose to meet their __________ needs. (energy/metabolic/elimination) 3. In diabetes mellitus, sugars accumulate in the __________. (kidneys/liver/bloodstream) 4. __________ diabetes mellitus usually starts later in life and occurs because the cells do not respond to the insulin. (Type I/Type II) 5. __________ diabetes mellitus results when the body produces little or no insulin. (Type I/Type II) 3

4. Vocabulary • Type I diabetes- Diabetes that results when the body produces little or no insulin • Type II diabetes- Diabetes that results when the body does not produce enough insulin or the cells do not respond as well to the insulin • Gestational diabetes- Temporary diabetes that develops in a pregnant woman • Hyperglycemia- A condition that results from not enough or a lack of insulin and too much sugar • Hypoglycemia- A condition that results from too much insulin and not enough or a lack of sugar in the blood • Insulin- A hormone needed to facilitate movement of glucose out of the bloodstream, across the cell membranes, and into the cells • Glucose- Sugar 4

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6. PROGRESS CHECK 1. ____________ is caused by too little insulin and too much blood sugar. (Hypoglycemia/Hyperglycemia) 2. ____________ is caused by too much insulin and too little blood sugar. (Hypoglycemia/Hyperglycemia) 3. You would suspect ____________ in a diabetic who has a viral respiratory infection and a fever. (hypoglycemia/hyperglycemia) 4. You would suspect ____________ in a diabetic who skipped lunch for an exercise session, but who took prescribed insulin anyway. (hypoglycemia/hyperglycemia) 5. Severe hyperglycemia may cause ____________ breath odor. (fruity/alcohol/no) 6. Hypoglycemia causes ____________ breath odor. (acetone/fruity/no) 7. The onset of hypoglycemia is ____________. (gradual/rapid) 6

7. First Aid Care of Severe Hyperglycemia(DKA) 1. Open the airway and provide artificial ventilation if necessary. 2. Check for signs of head or neck injury that may have occurred if the victim fell when losing consciousness; if any injuries are present, administer appropriate care. 3. Be alert for vomiting; position the victim on the side with the face pointed downward to prevent aspiration and allow drainage. 4. Treat for shock; keep the victim warm. 5. Monitor the airway, breathing and circulation vital signs every few minutes until emergency personnel arrive. 7

8. First Aid Care of Hypoglycemia 1. If the victim is able to obey commands and swallow, give orange juice, water with several tablespoons of sugar mixed in it, or other drinks that contain high amounts of sugar to help increase the blood sugar level. 2. If the victim is unable to obey commands or swallow, establish an airway and administer artificial ventilation if the volume or rate of breathing is inadequate. 3. Place the victim in a lateral recumbent position. 4. Continue to monitor vital signs until emergency personnel arrive. 8