Hypoglycemia Case Studies

The purpose of this study is to minimize the risk of hypoglycemia among the elderly. As people with diabetis age, the physiological changes affect the diabetic. The purpose of this study is to consider whether HbA1 goals can be attained without undue treatment burden and decrease the risk of severe hypoglycemia. Though client teaching and minimizing the risk factors of hypoglycemia can prevent further exacerbation of catastrophic events that could have potential lethal outcomes to an older patient with diabetes. The one patient’s case, Mr. J., an 86 year old man who has had type 2 diabetes for 15 years is a quantitative study that focuses on prevention of hypoglycemia in older adults. Interventions include diet, meal planning, medication, glucose

There were numerous limitations to the study; there was heterogeneity in the provision and reporting of nutritional supplementation, which may have influenced the results (Kramer et al., 2012). In implementing findings, nurses must closely monitor blood glucose levels in the intensive care unit. Due to the findings of this systematic review, nurses should implement moderate glycemic control to reduce the mortality rate in ICUs (Kramer et al., 2012).

Management of hypoglycemia consists of strategies such as prevention of hypoglycemia, use of therapeutic agents with low or no occurrence of hypoglycemia and treatment of hypoglycemia. It is important for the patient to understand and agree to adhere to treatment plan in terms of both medication and lifestyle modification. Self-monitoring of the glucose is very

Patients may benefit from early treatment with basal insulin added to oral antidiabetic drug (OAD) through early glycemic

In an implementation report by Roderman, Haire, and Hawley (2014), a study was initiated to determine if basal bolus insulin or other insulin regimens were more effective in achieving lower glucose and fewer hypoglycemia episodes. Patients who present with hyperglycemia and the inappropriate treatment of this state can prolong hospitalization, increase mortality rates, and put patients at risk for multi-organ complications. The use of subcutaneous sliding scale insulin is not an effective glycemic control tool because it is given without regards to carbohydrate intake and is contrary to normal pancreatic physiology (Roderman, Haire, & Hawley, 2014). In a few studies mentioned, overall mean blood glucose during hospitalization was lower in patients that had basal bolus insulin protocols versus sliding scale insulin protocols. Even with ADA and AACE recommendations of guidelines to use for optimal glycemic control, only 21% of hospitals in America had fully implemented non-critical care adult glycemic control protocols by 2008 (Roderman et al., 2014).

Living with diabetes poses many challenges for patients in areas like nutrition, glycemic monitoring and medication adherence. In fact, patients with diabetes

Preoperative assessment and evaluation of patients including those with diabetes undergoing elective surgical procedures provides optimum cardiopulmonary risk assessment and modification. Diabetes is a chronic illness that puts patients at a higher and complex intraoperative and postoperative complications (Fairburn & Elliot ,2014). This writer works in pre-surgical unit where patients undergoing surgical procedures under anesthesia are evaluated. For those patients with diabetes, glycemic control and optimization is part of the process. However, it remains to be an issue often leading to last minute surgery cancelations which can be very costly (Fairburn & Elliot ,2014) and/or not so optimal management of patients leading to untoward complications and increased length of stay.

Oral insulin would therefore be the best way to treat diabetic patients. Oral insulin replicates the precise physiologic pathway from portal vein into the liver as it is absorbed from the gastrointestinal tract, contrary to insulin injections which are absorbed in the systemic circulation and in the muscles (Arbit, 2009). This allows oral insulin to achieve a high porto-systemic gradient. This methodology of insulin absorption involves direct engagement of the liver, and its role in glucose metabolism is accentuated, leading to beneficial metabolic effects for diabetic patients. These effects include hyperinsulinemia (excess levels of insulin in the blood) reduction, prevention of weight gain associated with systemic insulin therapy, and reduction

The purpose was to identify if “preoperative medium-term (60-90 days) glycemic control, as reflected by HbA1c” is a pre-cursor to developing “mediastinitis, perioperative infarction, heart failure, stroke and kidney failure dialysis?” (Santos, et al., 2015, p. 280). The study used a prospective design with a stratified sampling plan and enrolled 170 patients for a period of two years. This research study was thorough with a domain of preventing post CABG complications through adequate preoperative glycemic control. In that, it provided evidence on the impacts of suboptimal glycemic control in relation to complications as well as increased length of stay. The validity of the study is recognized in the ways the data was randomized and compared with the controlled group, although it was limited to cardiac surgeries only. Thus, adding an extra layer of understanding on the importance of optimal glycemic control in the preoperative area. The study provided evidence that can be used as a guide to implement nursing practice change on preoperative glycemic control to promote patient

By identifying the associated clinical picture we need to be able to distinguish between possible pathologies that may be a likeable cause. However this may depend significantly on the practitioner’s capabilities to formulate a differential diagnosis and therefore relies on past experiences and wealth of retainable knowledge which may be open to inaccuracies as demographics, understanding, and world views, medical training all differs from person to person. As stated before a diagnosis cannot be deduced primarily on a clinical presentation as this may lead to either false positives/ negatives and should therefore be supported by diagnostic testing approaches. Capillary plasma glucose testing remains the most suited procedure in the prehospital setting as it non-invasive, rapid and simple to do. However, just like all other diagnostic evaluations it is at scrutiny for inaccuracies. Therefore should not be relied upon alone, and should rather be conducted in addition to a clinical presentation as suggested by Whipple’s triad. History is an important element in diagnosis as it may give a clear picture of possible

The study Serum Glucose Levels for Predicting Death in Patients Admitted to Hospital for Community Acquired Pneumonia: Prospective Cohort Study was published by the British Medical Journal (The BMJ) in the journal volume 344, number E3397, on May 29th of 2012. The study was conducted by consultant physician Philipp M. Lepper, consultant physician Sebastian Ott, statistician Eveline Nüesh, consultant physician Maximilian von Eynatten, consultant physician Christian Schumann, professor Mathias W. Pletz, statistician Nicole M Mealing, professor Tobias Welte, professor Torsten T Bauer, professor Norbert Suttorp, professor Peter Jüni, professor Robert Bals, and professor Gernot Rohde, on behalf of the German Community Acquired Pneumonia Competence Network (CAPNETZ). This article consisted of 12 pages and it purpose was to study the correlation between acute dysglycemia and death in patients admitted to hospital with community acquired pneumonia. The study was designed as a prospective cohort study between Germany, Switzerland, and Austria and it was conducted between 2002 and 2009. This prospective study supports the theory of previews smaller retrospective studies that show the association between hyperglycemia on hospitalization with mortality in patient with community acquired pneumonia.

Reactive hypoglycemia, a rare form of hypoglycemia, increases insulin levels after the consumption of excess carbohydrates, leading to a drop in blood glucose levels. This differs from conventional hypoglycemia where blood glucose drops several hours after a meal, but can easily be returned to normal by the consumption of food. Reactive hypoglycemia can cause fatigue, dizziness, shakiness, and in extreme cases, a coma. Although no effective treatments exist, glucagon, a peptide hormone derived from pancreatic alpha cells, seems to reduce symptoms. In the proposed experiment, the effectiveness of glucagon relative to a regimen of dietary control, exercise, and Acarbose will be tested on Zucker-diabetic-fatty (ZDF) rats (Rattus rattus). Three

This paper will contain information about hyperglycemia and hypoglycemia, the parts of the paper will talk about; the pathophysiology, the signs and symptoms, and the care priorities for each disorder. Read on to understand the two diseases discussed above.

Presently, insulin treatment is the primary medication with the confirmed capacity to convey any patient to glycemic objective at any position in the development of the disease. It is normally given after OADs have become ineffective, and unfortunately regularly soon after than is perfect. Glucose is the most important catalyst of insulin production; glucose amounts in healthy persons are kept within moderately constricted confines. The physiological plasma insulin outline in healthy persons exhibit little but steady insulin amounts in fasting circumstances, with jagged prandial peaks curtly (in 30 minutes) following meals followed by a gradual come back to basal levels when amplified insulin production is no longer essential. In order to steer clear of glycemic digressions, exogenously incorporated insulin would preferably strongly

Two hospital guidelines for DKA management currently being used by SLHD are from Liverpool Hospital and Royal Prince Alfred Hospital. They were analysed and both present objectives of their guidelines to be aimed at correcting acidosis, replacing fluid deficits, reversal of insulin deficiency and the correction of electrolyte imbalances (Liverpool Hospital 2015 and Hayman & Bein 2013). A literature search was undertaken on a range of databases including CINAHL, Medline, PubMed and Google Scholar. The key terms used were “diabetic ketoacidosis”, “adult”, “emergency care” and “nursing”. Limits were placed on the year published, ward based management was excluded and searches were restricted to the English language. The search yielded moderate results