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Diabetes and its acute complications 糖尿病及其急性併發症

2016-12-14
Preface

Diabetes is a chronic disease which requires early diagnosis and regular and prolonged treatment, or complications are likely to occur and to threaten health and life. There are three main acute complications: hypoglycemia, ketoacidosis, and hyperosmolar hyperglycemic syndrome.

Hypoglycemia
  • Definition: lower than normal blood glucose level (70 mg/100 mL).
  • Symptoms: There are sympathetic symptoms for the early stage when patients feel hunger, accelerated heartbeat, shivering, and sweating; and there are central nerve symptoms for the later stage when patients are troubled by dizziness, fainting, blurred vision, babbling, irritating disturbance, and even coma.
  • Causes: Insulin or oral hypoglycemic agent overdose, inadequate food intake or delayed meals, excessive exercise without food intake, and too much alcohol drinking.
  • Treatment:
     (1) If the patient is conscious, put 4-6 sugar cubes in his/her mouth or make him/her drink 120-150 c.c. of juice, coke or soft beverages. Have him/her take another round of sugar and drinks 10 minutes later until the symptoms are eased. If not, go to a hospital immediately.
    (2) If the patient is unconscious, drop one teaspoon of syrup in between his/her cheek and gum every 10 minutes and take him/her to a nearby hospital immediately.
    (3) Provide subcutaneous, intramuscular or intravenous glucagon injection.
  •  Prevention:
    (1) Have regular meals. Do not delay your meal time or eat less than you need.
    (2) Take extra snacks after vigorous exercises.
    (3) Maintain the amount of insulin or oral hypoglycemic agents you take.
    (4) Frequently monitor your blood glucose level.
Ketoacidosis & hyperosmolar hyperglycemic syndrome
  • Definition:
    • Ketoacidosis: 
      with blood glucose level significantly exceeding 300 mg/100 mL, and the combination of ketone bodies and metabolic acidosis; .
    • Hyperosmolar hyperglycemic syndrome: 
      When blood glucose level dramatically exceeds 600mg/100mL with the combination of increased blood osmotic level, there is no significant keton body and metabolic acidosis .
  • Symptoms: Thirst, polyuria, fatigue, skin dehydration, sunken eye sockets, accelerated heartbeat, lower blood pressure, conscious disturbance and coma. People with ketoacidosis also have the following conditions: nausea, vomiting, abdominal pain, and shortness of breath with fruit scents.
  • Causes:
    (1) Ignorance of undiagnosed diabetes.
    (2) Irregular treatment and inadequate control of blood glucose level.
    (3) Stressful situations: infection, injury, surgery, stroke, myocardial infraction.
  •  Treatment: Go to a hospital immediately.
  •  Prevention:
    (1) Regular treatment of diabetes.
    (2) Regular clinic follow-up.
    (3) Frequently monitor your blood glucose level.
    (4) Increase self awareness and go to a hospital timely.
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