: HYPOGLYCEMIA Prepared by: Neda M oaiedzadeh HYPOGLYSEMIA: HYPOGLYSEMIA PREPARED BY: NEDA MOAIEDZADEH INTRODUCTION : INTRODUCTION Definition : Definition Hypoglycemia is one of most feared complication of diabetes treatment. This is because it lead to a very uncomfortable feeling and a risk of losing of consciousness . & cause of the embarrassment in the social or work setting. Normal physiologic response: Normal physiologic response Supration of insulin release from the pancreas Secretion of glucagon. Secretion of epinephrine & norepinephrine . Secretion of growth hormone. Secretion of cortisole . CAUSES of HYPOGLYCEMIA: CAUSES of HYPOGLYCEMIA PowerPoint Presentation: It occurs due to a relative excess of insulin in the blood, which in turn lowers the blood glucose to below normal levels. This relative excess of insulin can be due to : Too much medication causing higher than needed insulin levels. Poor insulin injections.(IM) Incorrect dose . Forgetting correct dose of insulin. Unable to match of insulin dose & exercise or CHO Visual problem. The prolong action of certain medication. Alcohol consumption PowerPoint Presentation: Not eating enough food to match the insulin level in the blood stream. Not eating at the proper time. Skipping meals PowerPoint Presentation: Up planed or excessive exercise leading to lower blood glucose. The level of glucose when symptoms appear varies from person to person.: The level of glucose when symptoms appear varies from person to person. CLINICAL MANIFESTATION: CLINICAL MANIFESTATION PEOPLE WITH DIABETES May feel different symptoms as their blood glucose levels fall below normal. The initial symptoms are as a result of the release of epinephrine ,the adrenergic response. PowerPoint Presentation: The hypoglycemia reaction may range from a very mild 60-70 mg/dl minimal or no symptoms, To severe <40 mg/dl & neurological impairment PowerPoint Presentation: Hypoglycemia can be categorized to: Mild Moderate Severe MILD HYPOGLYCEMIA: MILD HYPOGLYCEMIA MILD HYPOGLYCEMIA: MILD HYPOGLYCEMIA Sudden hunger Headache Shaking Fast or pounding heart beat Sweating Tired Dizzy Blurred vision Nervous & Excited Drowsy Numbness or tingling around mouth or lips MODERATE HYPOGLYCEMIA : MODERATE HYPOGLYCEMIA MODERATE HYPOGLYCEMIA : MODERATE HYPOGLYCEMIA Personality changes. Irritability Confusion Poor coordination Difficulty concerning. Slurred or slow speech Severe hypoglycemia : Severe hypoglycemia Severe hypoglycemia : Severe hypoglycemia Coma Seizures TREATMENT: TREATMENT Treatment should be prompt. When possible the presence of hypoglycemic symptoms should be checked with the blood glucose monitor. MILD TO MODERATE HYPOGLYCEMIA: MILD TO MODERATE HYPOGLYCEMIA MILD TO MODERATE HYPOGLYCEMIA: MILD TO MODERATE HYPOGLYCEMIA The rule of 15 is a helpful way to remember the treatment regimen. for example: 15 gr quickly absorbed carbohydrate. Wait 15 minute. If not better or blood glucose is not above 60 mg/dl ,treat with another 15 gr of quickly absorbed CHO. As this quickly absorbed CHO will not last long in the body ,it is important that the person is given something to eat within a short time. PowerPoint Presentation: If the next meal time is more than 1 hour away the person should be given some food rich in CHO & protein, such as sandwich, a fruit with milk or a small chappati with dal . This will ensure that the blood glucose dose not drop again before the next meal. When any person with diabetes who is at risk of hypoglycemia is traveling they should be advised to carry sugar cubes, glucose tablets & glucose biscuits to manage hypoglycemia. Severe Hypoglycemia: Severe Hypoglycemia Severe Hypoglycemia: Severe Hypoglycemia If the person is conscious, able to swallow , they should be given 20 gr of quickly absorbed CHO. followed by same regimen as told. If the patient is unconscious , they will not able to swallow and must not be given any thing orally. They should be taken to an emergency facility where dextrose can be administered intravenously . PowerPoint Presentation: If glucagon is available ,it should be given promptly by a family member of friend who has been instructed in its use .(patient is unconscious &unable to swallow). Glucagon is injected in the same manner as insulin . The patient will usually wake up in 15 min. They may be nauseated and should be given something to eat that they can tolerate . Prevention: Prevention Prevention : Prevention Treatments should always be followed by some investigations, as to why hypoglycemia occurred & what could be done to prevent its occurrence. Cause such as not eating on time etc & unexplained hypoglycemia for which know cause can be determined. People should be asked to make a note of the following: PowerPoint Presentation: When the low blood glucose occurred? How they were feeling , what symptoms they had. What the blood glucose level was , if they were able to do a test. What they were doing at the time of hypoglycemic event? What they had been doing prior to the event? Any particular event they think might have had an impact on blood glucose levels. What they did to correct it. Summary : Summary Conclusion : Conclusion ANY DOUBT???: ANY DOUBT???