Diabetic Emergencies

Recorded live at HYMS - Ed discusses diabetes management with a particular focus on emergencies - hypoglycaemia and DKA.

 

Lecture by

Video Duration: 20 minutes

  • Diabetic Emergencies
    Created by Katherine Ellison
    General
    Epidemiology

    HYPOGLYCEAMIA: Common problem especially with diabetes mellitus

    Pathology

    Low blood sugar < 5mmol/l

    Top three causes
    • Insulin + Sulphonylureas
    • Hepatic Disease + Alcohol
    • Addison's
    Clinical Features
    Symptoms

    Sympathetic Mediated 2.5-3mmol/l

    • Tachycardia
    • Anxiety
    • Hunger
    • Nausea/Vomiting

    Centrally Mediated <2.5mmol/l

    • Disorientation
    • Confusion
    • ...Eventually coma
    Signs

    Sympathetic Mediated 2.5-3mmol/l

    • Sweating
    • Pallor
    • Dilated pupils

    Centrally Mediated <2.5mmol/l

    • Blurred Vision
    • Slurred Speech
    Investigations
    Cultures

    Urine dipstick test for glucose

    Bloods

    Blood Glucose

    ?HbA1c

    ?LFTs

    ?TFTs

    Imaging

    None

    Scopic/Biopsy

    None

    Functional

    None

    Treatment
    Conservative

    Patient able to swallow:

    Oral glucose, followed by complex carbohydrates

    Severe:

    Do ABCs

    • A - Airway
    • B- Breathing
    • C- Circulation ... Don't Ever Forget Glucose

    And MOVE

    • M - Monitor
    • O - Oxygen
    • V - Venous access
    • E - ?ECG

    1mg IM Glucagon

    OR (e.g. Liver disease) IV Dextrose 20%

    Medical

    None

    Surgical

    None