Undiagnosed Diabetes

Undiagnosed Diabetes Determining And Coping With Emergencies 2021

Undiagnosed Diabetes : In some cases, a person may reach the point of diabetic ketoacidosis (DKA). Such as being overweight or physically inactive, often misdiagnosed.

Undiagnosed Diabetes : Determining and coping with emergencies

# Acute complications of Undiagnosed Diabetes

* Hypoglycemia

♥ Definition

  1. -When the blood sugar is less than 50-70 mg/dL and there is symptoms of hypoglycemia
  2. -If the blood sugar has been high for a long time or if the high blood sugar suddenly drops, the blood sugar decreases. Hypoglycemia symptoms may appear even if the content is more than 70mg/dL

♥ Risk factors-In the case of type I diabetes or type II diabetes

– It may occur when the amount of oral hypoglycemic drugs or insulin is excessive, or when the balance between diet and exercise is broken.

Meals

  • √ If mealtimes irregular
  • √ If you drink alcohol on an empty stomach
  • √ If there is insufficient carbohydrate intake
  • √ If the meal or snack runs delay or skip
  • √ If you have vomiting or diarrhea, severe

kinetic

  • √ If an empty exercise in
  • √ long time Gross If you exercise
  • √ If you do not eat snacks when necessary

Drugs

  • √ If the dosage time is irregular
  • √ If the amount of insulin injected or the dose of oral medicine is high

♥ Symptoms (Comes urgently within a few minutes-a few hours) → Symptoms of Undiagnosed Diabetes and symptoms of hypoglycemia There are individual differences

  1. -When hypoglycemia occurs, the sympathetic nerve is initially excited in response to raising blood sugar, and
    hormones that raise blood sugar are secreted (a kind of hypoglycemic warning signal), and ingestion of sugar
    can immediately recover
  2. -beyond this period, hypoglycemia If this persists, you
    lose consciousness with a headache, and in severe cases, you become completely unconscious, leading to a very dangerous situation.
    ? Symptoms of hypoglycemia
    ① I am hungry.

    ② I have a cold sweat, my heart is beating and I am anxious.
    ③ My whole body trembles and my fingertips are numb.

♥ First Aid (if hypoglycemia occurred respond)

  1. – Which states of consciousness : simple sugars 15g (sweetness that the effect quickly raise blood sugar, I drinks or food) offering, 15 minutes and 30
    do not improve symptoms minute one monosaccharide 15g comes back, twice If it does
    not improve after serving, immediately evacuate to the hospital
    ※ 15g of monosaccharides : 1/2 cup of orange juice, 3-5 candies, 1 cup of milk, 1 bottle of yogurt, 1/2 can of cola, 1 ice cream, 1 spoon of honey
  2. – Unconscious Condition : As there is a risk of suffocation, never try to feed it, and you should immediately go to the nearest hospital to get a glucose injection. (50% glucose intravenous administration or 5-10% D/W intravenous drip +Glucagon IM)
  3. -After that, when the blood glucose measurement level returns to within 80-130mg/dl, take complex sugars (cheese, crackers,etc.) and protein. (Continuous per supply) Precautions for hypoglycemia.
  4. Avoid foods containing a lot of fat as blood sugar recovery is slow.
  5. Take care not to become hyperglycemic by ingesting too much emergency foods for hypoglycemia Foods to watch out for.
  6. -Chocolate, potato chips, cookies, pizza, sweetened yogurt, donuts, ice cream, alcohol, cake, honey cake, canned fruit

♥ Prevention

– Preventive measures for diabetics who take insulin injections or use oral hypoglycemic drugs

  • ① Always use regular meals The amount should be taken at a certain time and should not be filtered.
  • ② You must keep the medication taking time, know the exact method for insulin dose control, and adjust the dose of the drug according to the blood sugar test .
  • ③ Always carry candy, chocolate, and sweets with you for urgent times.
  • ④ When you plan to exercise severely, reduce the amount of insulin or increase the amount of meal in advance. One method is to consume small amounts of sugar at intervals of an hour or two while exercising.
  • ⑤ If hypoglycemia occurs frequently without any special reason, consult a doctor. Drugs in use Care should be taken to avoid hypoglycemia by adjusting the water dose or reducing the insulin injection dose .

▶ Recent Issues

-Hypoglycemic shock while driving a bus driver suffering from diabetes-

* Source: Chosun Ilbo  

A city ​​bus driver suffering from diabetes(Undiagnosed Diabetes) deviated from the route in a hypoglycemic shock state and drove a car accident and killed one person. In this accident, Mr. Jeong Mo, 61, a truck driver, was injured and transferred to the hospital, but died. The bus driver, Jeong, wasn’t hurt much.

However, the doctor who treated Chung, a bus driver who was transferred to the hospital after the accident, diagnosed that he was in hypoglycemic shock while driving the bus.
Hypoglycemic shock occurs when diabetics do not eat or take medications properly. When it reaches this state, the body is drooping, judgment is blurred, and even fainting occurs in severe cases.

The current Passenger Vehicle Transportation Business Act prohibits only those who take drugs or commit violent crimes from driving a bus, but there is no regulation for diabetic drivers.
It is known that Jeong, who had diabetes symptoms, had been driving with regular insulin injections.

  1. → In connection with the recent city bus accident, the fact that the driver is suffering from diabetes has been found, and interest in ‘hypoglycemic shock’ is increasing.
  2. → Hypoglycemic shock, also called insulin shock, is low blood sugar and high blood sugar in radio immunoassay Shows the insulin concentration in the fluid. When hypoglycemia occurs, cold sweats occur, a feeling of hunger is felt, hands tremble, pulse is accelerated, and concentration is reduced. In severe cases, it can lead to loss of consciousness or even life .
  3. → As in the case above, even in a state of hypoglycemic shock, apparent symptoms such as continuing work may not appear, but the person is unconscious.
  4. → As hypoglycemic shock can interfere with daily life and lead to death in severe cases, it
    is necessary to manage blood sugar and prevent it.

* DKA Diabetic Ketoacidosis

♥ Definition

-This is an emergency condition characterized by high blood sugar, dehydration, electrolyte loss, and acidosis when insulin is remarkably insufficient or not produced . It occurs mainly in type 1 diabetes, but rarely occurs in type 2 diabetes “Undiagnosed Diabetes”.

♥ Cause

  1. -When the amount of insulin is remarkably insufficient or not at all-Inadequate
    treatment of undiagnosed diabetic subjects or diagnosed patients
  2. -Stressful situations (emotional stressful situations such as puberty, cardiovascular disorders, surgery, pregnancy)

♥ Pathophysiology

  1. -Insulin deficiency -Decreased glucose entering the cell / new glucose in the liver → high blood sugar
  2. – Moisture in the kidney, electrolytes, glucose emissions – Sophora teeming diuretic → dehydration, electrolyte loss insulin deficiency
  3. – adipocyte fatty acid, decomposed into glycerol
  4. -fatty acid metabolic acidosis → switch circulatory accumulation of ketone bodies in the liver, coma caused

♥ Symptoms of Undiagnosed Diabetes (some Time-Comes gradually over several days.)

diabetes symptoms

  1. -Mainly in case of type II diabetes
  2. -Acidosis (Incomplete burning of stored fat due to the inability to use glucose as an energy source accumulates ketone bodies, a metabolite of fat): Changes in consciousness level, Acetone odor during breathing
    Ketoacidosis: Kussmaul breathing, a unique breathing type that a severely diabetic patient in a coma
  3. -Dry mucous membrane, warm and dry skin, reddish appearance, low blood pressure, tachycardia (dehydration)

♥ Coping

  1. –  Admission to the emergency room quickly and fast
  2. – Acting Administer insulin
  3. – Or administer physiological saline with insulin to correct dehydration
  4. -Administer bicarbonate (NaHCO3- ) to correct acidosis if pH is less than 7.0 Undiagnosed Diabetes – * HHNS Hyperglycemia Hyperosmolar nonketic coma Hyperglycemic hyperosmolar nonketic coma

♥ Cause

  1. – Undiagnosed diabetes, infection , Stress, parenteral nutrition, dialysis, large burns treated with high sugar concentrations
  2. -Inducing drugs: diuretics (K excretion)-mannitol, steroid, etc.

♥ symptoms (a few hours – it comes slowly over several days)

  1. – High blood sugar (ketone is not osmotic pressure ↑)
  2. – dehydration
  3. – ketone Not acidosis is not because it does not produce
    → changes in level of consciousness, nausea and vomiting does not come, kusmaul breathing It is similar to DKA except for the smell of acetone when over breathing

♥ First aid treatment

  1. -Admitted to the emergency room to quickly administer fast-acting insulin
  2. -Dehydration: Insulin and intravenous administration of half-concentration physiological saline → Since it is not acidosis, it is not necessary to observe serum K. Rapid fluid and fast
  3. -Acting insulin supply

* Prevention of acute complications?

If a diabetic patient loses consciousness, the only option is to see a doctor and treat it as soon as possible .

→ If you receive treatment quickly in the early stages of a coma, you will recover, but if you miss the timing, your life may be at risk

Precautions for the prevention of acute complications

1. Regular blood sugar testing is essential and good blood sugar management is usual.
2. Eat and exercise regularly.
3. If you have an infectious disease, seek medical attention immediately, and if you are sick or unable to eat due to gastrointestinal disease,
follow the rules for sick days.
4. Always carry your diabetes treatment notebook and record the name and dose of the medication you are taking.
5. Know the contact information of the public health center, the primary practitioner, and the emergency medical center.

Diabetes Symptoms : Early Signs And Type 1, Type 2 Diabetes Symptoms | Causes, Treatment, Prevention

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