Interactive Ready for Review: Interactivities

is a metabolic disorder caused by the lack of insulin, a hormone that enables glucose to enter the cells, where it can be used for energy. %%1%% is typically characterized by excessive urination and resulting thirst, along with deterioration of body tissues.

There are two types of diabetes. , or insulin-dependent diabetes, usually starts in childhood and requires daily insulin to control the blood glucose level. , or non-insulin-dependent diabetes, usually develops in middle-age patients and can often be controlled with diet and oral medications. Both are serious systemic diseases that affect the kidneys, eyes, small arteries, and peripheral nerves, especially if the disease is uncontrolled or poorly controlled.

Patients with diabetes have chronic complications that place them at risk for other diseases such as myocardial infarction, stroke, and infections. Most often, however, you will be summoned to treat the acute complications of blood glucose imbalance. These include (excess blood glucose) and (low blood glucose).

Symptoms of hypoglycemia classically include confusion; rapid respirations; pale, moist skin; diaphoresis; dizziness; fainting; and even coma and seizures. This condition, called , is rapidly reversible with the administration of glucose, in oral or IV form. Without treatment, permanent brain damage and death can occur.

Hyperglycemia is usually associated with dehydration and ketoacidosis. It can result in , marked by rapid (often deep) respirations; warm, dry skin; a weak pulse; and a fruity breath odor. Hyperglycemia must be treated in the hospital with insulin and IV fluid rehydration.

Since either too much or too little blood glucose can result in altered mental status, you must perform a thorough history and patient assessment. When you cannot determine the nature of the problem, it is best to treat the patient for . Be prepared to give oral glucose to a conscious patient who is confused or has a slightly decreased level of consciousness and D50 to an unresponsive patient. Do not give oral glucose to a patient who is unresponsive or otherwise unable to swallow properly or protect his or her own airway.

Remember, in all cases, providing emergency medical care and prompt transport is your primary responsibility.