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Acute Complications of DM
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Somogyi Effect
Mourning hyperglycemia from a counter-regulatory response to night time hypoglycemia
Treat somogyi effect
less insulin
check blood sugar b/n 2 & 4am
if b.s is low reduce am insulin
Dawn Phenomenon
hyperglycemia from a nighttime release of growth hormone that causes b.s elevations at about 5am to 6am
Treat Dawn Phenomenon
change in timing of dose (later)
more insulin & bedtime snack
check b.s b/n 2 & 4am
DKA-Diabetic Ketoacidosis
TYPE I Problem
Profound defiency of insulin
BS>300
Dehydration
Fruity breath
Kussmaul Respirations
anorexia
n/v
(metabolic acidosis)
weakness, lethargic
electrolyte imbalance
lead to coma
death
Management Ketoacidosis
Continuous IV infusion of insulin
I/V hydration w/ NSS initially
electrolyte replacement
HHS- Hyperglycemic Hyperosmolar State
TYPE II Problem
produce enough insulin to prevent DKA
not enough insulin to prevent hyperglycemia, osmotic diuresis or ECF depletion
Inc in serum osmolarity
BS>400
ketones are absent
Treatment of DKA & HHS
medical emergency
IV NSS or 1/2 NSS
IV Reg Insulin
BS below 250 add IV Glucose (D5 1/2)
Electrolyte Replacement
Cardiac Monitoring (high K)
Lipoatrophy
loss of fat tissue in areas of repeated injection that results from an immune reaction to impurities in insulin
Treat Lipoatrophy
injection of insulin at the edge of the atrophied area
Lipohypertrophy
increased swelling of fat that occurs at the site of repeated insulin injection
Treat lipohypertrophy
rotating injection injection site among different body areas
Author
cris_tal1303
ID
10985
Card Set
Acute Complications of DM
Description
Acute Complications of DM
Updated
2010-03-17T19:43:25Z
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