Acute Complications of DM

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Acute Complications of DM
2010-03-17 15:43:25

Acute Complications of DM
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  1. Somogyi Effect
    Mourning hyperglycemia from a counter-regulatory response to night time hypoglycemia
  2. Treat somogyi effect
    • less insulin
    • check blood sugar b/n 2 & 4am
    • if b.s is low reduce am insulin
  3. Dawn Phenomenon
    hyperglycemia from a nighttime release of growth hormone that causes b.s elevations at about 5am to 6am
  4. Treat Dawn Phenomenon
    • change in timing of dose (later)
    • more insulin & bedtime snack
    • check b.s b/n 2 & 4am
  5. 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
  6. Management Ketoacidosis
    • Continuous IV infusion of insulin
    • I/V hydration w/ NSS initially
    • electrolyte replacement
  7. 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
  8. 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)
  9. Lipoatrophy
    loss of fat tissue in areas of repeated injection that results from an immune reaction to impurities in insulin
  10. Treat Lipoatrophy
    injection of insulin at the edge of the atrophied area
  11. Lipohypertrophy
    increased swelling of fat that occurs at the site of repeated insulin injection
  12. Treat lipohypertrophy
    rotating injection injection site among different body areas