You are required to reflect on your practice as a

Acute Complications of Diabetes Mellitus (DM) All three acute complications of diabetes are summarized in the table below. In addition, can you match the synonyms and typical onset of each? Hypoglycemia DKA HHNKS Synonyms Risk Factors Taking insulin Rapidly fluctuating blood glucose levels Sulfonylurea agents (Type 2 Diabetes) Individuals with type 1 diabetes Individuals with non-diagnosed diabetes Older adults or very young individuals with type 2 diabetes, nondiabetic individuals with predisposing factors, such as pancreatitis; individuals with undiagnosed diabetes Predisposing Factors Excessive insulin or sulfonylurea agent intake Decreased food intake, Excessive physical exercise Stressful situations: Infection Trauma Emotional stress Omission of insulin Medications that antagonize insulin Infection Medications that antagonize insulin Typical Onset Presenting Symptoms Adrenergic reaction: pallor, sweating, tachycardia, palpitations, hunger, restlessness, anxiety, tremors Neurogenic reaction: fatigue, irritability, headache, loss of concentration, visual disturbances, dizziness, hunger, confusion, transient sensory or motor defects, convulsions, coma, death Malaise, dry mouth, headache, polyuria, polydipsia, weight loss, nausea, vomiting, pruritus, abdominal pain, lethargy, shortness of breath, Kussmaul respirations, fruity or acetone odor to breath Polyuria, polydipsia, hypovolemia, dehydration (parched lips, poor skin turgor), hypotension, tachycardia, hypoperfusion, weight loss, weakness, nausea, vomiting, abdominal pain, hypothermia, stupor, coma, seizures Laboratory Analysis Serum glucose <55-60 mg/dL in adults Glucose levels >250 mg/dL, Decreased bicarbonate concentration;Increased anion ga Glucose levels >600 mg/dL, No ketosis serum osmolarity >320 mOsm/L Elevated BUN and creatinine Hyperosmolar hyperglycemia nonketotic coma Slowest Slow Rapid Insulin shock, insulin reaction Diabetic coma syndrome

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