Diabetes Mellutis -
A metabolic disorder in which the body cannot metabolize glucose,
usually due to a lack of insulin.
|THERE ARE 16 MILLION DIAGNOSED CASES
OF DIABETES IN THE U.S. TODAY. MORE
THAN 5 MILLION PEOPLE LIKELY HAVE THE
CONDITION BUT REMAIN UNDIAGNOSED.
Because of the prevelance of Diabetes, it is a common
encounter in the EMS field. We frequently deal with patients that are
having a Diabetic problem. A basic understanding of the Diabetic problems
and how to handle them is essential.
also called low blood sugar,
occurs when your blood glucose (blood sugar) level drops too low to provide
enough energy for your body's activities. Can also be referred to as Insulin
Shock Usually has a rapid onset.
high blood sugar - food
with insufficient insulin - Has a Slow onset - Also known as DIABETIC COMA.
a form of sugar, is an important
fuel for your body. Carbohydrates are the main dietary sources of glucose.
Rice, potatoes, bread, tortillas, cereal, milk, fruit, and sweets are all
carbohydrate-rich foods. After a meal, glucose molecules are absorbed into
your bloodstream and carried to the cells, where they are used for energy.
Insulin, a hormone produced by your pancreas, helps glucose enter cells. If
you take in more glucose than your body needs at the time, your body stores
the extra glucose in your liver and muscles in a form called glycogen. Your
body can use the stored glucose whenever it is needed for energy between
meals. Extra glucose can also be converted to fat and stored in fat cells.
When blood glucose begins to fall, glucagon, another hormone produced by the
pancreas, signals the liver to break down glycogen and release glucose,
causing blood glucose levels to rise toward a normal level. If you have
diabetes, this glucagon response to hypoglycemia may be impaired, making
it harder for your glucose levels to return to the normal range.
When blood glucose rises, several other problems occur. The blood becomes
acidic causing a condition known as "Ketone Acidosis". Acidosis is what
happens in the body when not enough insulin is available. Blood sugar is
usually high at this time. Moderate or large ketones are present in the
urine or blood and then build up in the body. The ketones make the body
fluids more acidic resulting in total body acidosis.
SIGNS & SYMPTOMS:
|Appearnce||Extremely ill||Very weak
|Skin||Red and dry||Pale||
|Respiratory||Exaggerated air hunger (Kussmaul Respirations)||Normal-Shallow
|Pulse||Rapid||Normal or may be rapid||
|Mental Status||Restless,merging into unconsciousness||Apathy, irritibility merging into unconsciousness||
- Glove are always appropriate
- If vomiting, may need glasses and additional protection.
SCENE SIZE UP
- Is the scene secure?
- Present danger or evidence of trauma
- Is there family or friends around
- Are there any medications or drugs close by
- General Impression
- Airway, Breathing, Circulation
- Chief complaint, Life threats
- Identify Altered Mental Status
- High flow O2
- Priority for transport
- History of the present event
- How did the episode occur (MOI)?
- time of onset? Slow or Fast?
- duration ?
- associated symptoms?
- evidence of trauma?
- have there been any interventions?
- Is the patient alert enough to be able to swallow?
- PAST MEDICAL HISTORY
- LAST ORAL INTAKE!!!!!
- EVENTS LEADING UP TO ILLNESS
- MEDICAL ID BRACELET OR CARD
- Does the patient have a history of diabetes?
- Have they taken their insulin?
- Did they miss a meal after taking Insulin?
- Have they vomited after eating?
- Did they have unusually vigorous exercise?