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Hypoglycemia and Hypoglycemia Treatment in DM Patients

What is the BG l cutoff level of hypoglycemia ? BG < 70 mg/dL
What are some of the common s/sx of hypoglycemia? 1- dizziness 2- headache 3- anxiety 4- irritability 5- shakiness 6- diaphoresis ( sweat) 7- hunger 8- N 9- Confusion, lack of coordinations 10- tremors 11- palpitations ( fast HR) 12- blurry vision
What are some of the s/sx of SEVERE HYPOglycemia? 1- coma 2- seizure 3- death
Which class of anti DM drugs associated with high risk of drug induced hypoglycemia? 1- insulin 2- SU 3- Meglitinides 4- Pramlintide 5- other drugs are high risk when used in comb with insulin
Which class of drug masks the s/sx of HYPOglycemia? - beta blocker - prevents recognition of hypoglycemia --> severe form develops
which s/sx of hypoglycemia Beta blocker masks? 1- shakiness 2- palpitations 3- anxiety
which s/sx of hypoglycemia beta blocker DO NOT mask? - sweating - hunger
Which beta blocker drugs exacerbate insulin- induced hypoglycemia and delay the recovery of blood glucose? - NON selective beta blocker - carvedilol and propranolol
what is the rule of hypoglycemia treatment? - RULE OF 15 1- take 15-50 gram glucose/ simple carbs 2- recheck in 15 min 3- repeat 4- give small meal/ snack
What to avoid in pt with hypoglycemia? - avoid adding fat as it delay the absorption and prolong hypoglycemia
what are some examples of 15 gram simple carbs? - 3-4 glucose tab - 1 serving of glucose gel - 2 TABLEspoon of raisins - 1 TABLE spoon sugar, honey or corn syrup - 1/2 cup juice or soda - 1 cup of milk
Which patients population should Glucagon ( GlucaGen) be prescribed for? - pt with high risk of severe hypoglycemia
When is the use of GlucaGen indicated? - patient is unconscious - not conscious enough to self treat
Why patient should be placed on side ( lateral recumbent position) prior to injecting GlucGen? - to protect the airway - to prevent chocking
what is the GlucGen recommended dose? - 1 mg ( ONE mili gram ) - SC, IM or IV - check in 15 min, if still hypoglycemia, give another 1 mg
What is the targeted d blood glucose for inpatient? - inpatient/ hospitalized pt: 140-180mg/dL -
Why the sliding scale ( SSI) method is no longer recommended? - b/c it administers insulin in response to elevated blood sugar - it treats elevated blood sugar, not preventing it & it's not pt specific --> poor outcomes
Which approach is recommended to be used in hospital setting ( as SSI is no longer recommended)? - more proactive : controls BG and prevents complications - this includes: basal, bolus and correction dose - the correction dose is more pt specific vs. SSI
which approach is recommended to be used in non critically ill pt? - more proactive: controls BG and prevents complications - based on pt food intake: 1- poor intake: basal + correction dose 2- eating adequately: basal+ bolus + correction dose
Which insulin formulation and conc is used in hospital setting? - U-100 - Give as IV - short acting regular insulin U-100 - rapid acting insulin
Created by: Smoham38



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