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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:

( 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 250 mg/dL, and the combination of ketone bodies and metabolic acidosis; 

•  Hyperosmolar hyperglycemic syndrome :

When blood glucose level dramatically exceeds 600mg/dL with the combination of increased blood osmotic level, there is no significant ketone 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.

• Treatmen t : 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.