Preventing And Handling Diabetic Emergencies
Caring for a pet with diabetes can be daunting. Fortunately, the key to successful diabetes management is simple: a consistent, established daily routine. A healthy diet is essential, and feeding your pet the same amount of food at the same time every day will help make blood sugar easiest to control. Your pet will usually also need twice-daily insulin injections, which should be given at the same time every day. (The easiest way to do this is to coordinate shots with mealtimes.) Routine daily exercise and regular at-home monitoring of urine and/or blood sugar round out a plan for good diabetic regulation. Even if you are following a consistent routine, a diabetic pet may occasionally experience an emergency. A number of different things can cause an emergency, but the most common is hypoglycemia, or low blood sugar. In this case, it is important that you be prepared in order to avoid a life-threatening situation. Hypoglycemia: Why It Happens Hypoglycemia most often results from accidental overdosage of insulin, but it can also occur if a pet is not eating well, misses a meal or vomits after eating, or if the type and amount of food he is being fed changes. Hypoglycemia may become a problem with very vigorous exercise; for this reason, regular daily controlled exercise is best. Hypoglycemia can also result if the body’s need for insulin changes. This scenario is particularly common in cats who often return to a non-diabetic state once an appropriate diet and insulin therapy start. Vet Tips Avoid “double-dosing” insulin. Only one person in a household should have the responsibility of giving insulin. A daily log should be kept of the time/amount of food and insulin that is given to avoid errors. Proper daily monitoring of blood and/or urine glucose can help identif Continue reading >>
Hypoglycemia means low (hypo) glucose (gly) in the blood (emia). Your body needs glucose to properly function. Your cells rely on glucose for energy. Glucose comes from the foods you eat. Carbohydrates (e.g., fruit, bread, potatoes, milk, and rice) are the biggest source of glucose in a typical diet, and your body breaks down carbohydrates into glucose. The glucose is then transported in your blood to cells that need it; it gives your body energy. However, in order to use the glucose, your body needs insulin. This is a hormone produced by the pancreas. Insulin helps transport glucose into the cells, particularly the muscle cells. Sometimes, your blood glucose level can drop too low—that's hypoglycemia. It usually happens quite quickly, and it can be handled quite quickly, as well. People with type 1 diabetes do not make insulin to help their bodies use glucose, so they have to take insulin, which is injected under the skin. People with type 2 diabetes fall into two categories when it comes to insulin: either their body doesn't make enough, or their body is unable to use it well (insulin resistance). Normal Blood Glucose The American Diabetes Association published the Standards of Medical Care in Diabetes that provide recommended target blood glucose ranges for people with and without diabetes. The standard for measuring blood glucose is “mg/dL,” which means milligrams per deciliter. People without Diabetes After eating (called postprandial) 70 to 140 mg/dL Goals for People with Diabetes Type 2 diabetes (also called type 2 diabetes mellitus) is more common than type 1 diabetes. Around 90 to 95 percent of people with diabetes have type 2 diabetes. According to the Centers for Disease Control and Prevention’s National 2014 Diabetes Statistics Report, 29.1 million A Continue reading >>
Hypoglycemia is what every diabetic fears -- very low blood glucose. Since the brain requires glucose for fuel at every second, it's possible to induce coma, seizures,brain damage and death by letting blood glucose drop too low. Because the brain is almost totally dependent on glucose to make use of oxygen, it is somewhat like having severe breathing problems. Though the causes and mechanisms are different, in both cases the brain does not have enough oxygen, and similar symptoms and problems can occur. It is caused by giving too much insulin for the body's current needs. The blood glucose level at which an animal (or person) is dangerously hypoglycemic is fuzzy, and depends on several factors. The line is different for diabetics and non-diabetics, and differs between individuals and depending on exogenous insulin and what the individual is accustomed to. The most likely time for an acute hypoglycemia episode is when the insulin is working hardest, or at its peak; mild lows may cause lethargy and sleepiness. An acute hypoglycemic episode can happen even if you are careful, since pets' insulin requirements sometimes change without warning. Pets and people can have hypoglycemic episodes because of increases to physical activity. What makes those with diabetes prone to hypoglycemia is that muscles require glucose for proper function. The more active muscles become, the more their need for glucose increases. Conversely, there can also be hyperglycemic reactions from this; it depends on the individual/caregiver knowing him/herself and the pet's reactions. According to a 2000 JAVMA study, dogs receiving insulin injections only once daily at high doses are more likely to have hypoglycemic episodes than those who receive insulin twice daily. The symptoms Continue reading >>
Diabetes And Seizures: What Are They? What Are The Symptoms?
Having a seizure is a very serious thing. It is dangerous for the person experiencing it, and it is also scary for those nearby. Seizures can be caused for several reasons. Some people have epilepsy, which is a disorder where seizures happen often. For those without epilepsy, they are often called “provoked seizures” because they were provoked, or brought on, by something reversible. Individuals with diabetes can experience these “provoked seizures” when their blood sugar drops too low. The following article explains the difference in these, how to prevent them, and how to care for someone that is having a diabetic seizure. The difference between epilepsy and seizures Epilepsy is a seizure disorder that happens because there is an electrical storm in the brain. People have recurrent seizures that involve loss of consciousness, convulsions, abnormal behavior, disruption of senses, or all of the above. Some have an “aura” before having a seizure and know when it is going to happen. Most causes of epilepsy are unknown, however they can be triggered by flickering light, loud noises, or physical stimulation. Treatment for this condition includes medications and sometimes diet changes. A “provoked seizure” happens because something abnormal is happening in the body. This can include low sodium, fever, alcohol, drugs, trauma, or low blood sugar. The same thing happens as with epilepsy, and there is unusual activity in the brain causing abnormal movements and behaviors. Unlike epilepsy though, where a seizure can happen for no reason, there is an actual cause for each one that occurs for “provoked seizure”. It is important to understand the cause of these so that preventative measures can be taken. There is no relationship between epilepsy and diabetes. One Continue reading >>
What Is A Diabetic Seizure? Know The Signs And Symptoms
As people with diabetes, we should all be very familiar with hypoglycemia but for those who are not, what is hypoglycemia and how can it effect us? Hypoglycemia is the clinical syndrome that results from low blood sugar. The symptoms of hypoglycemia can vary from person to person, as can the severity as I’ve personally dealt with in the past when my severe low was accompanied with a seizure. This was the first time this as ever happened to me since being diagnosed as a type 1 diabetic over 10 years ago now. While I don’t remember the seizure itself, let’s just say we made it a memorable experience for the community as it happened at my sons fall soccer tournament. So what is a hypoglycemic seizure and what are the warning signs of having a seizure? Let’s take a closer look! What Is a Hypoglycemic Seizure So what causes a seizure? A hypoglycemic seizure may be triggered by injecting too much insulin, or failing to eat soon enough after using a fast acting insulin (exactly what happened to me); excessive use of alcohol, skipping meals, or exercising vigorously without adjusting insulin dosages or eating properly. A seizure may also be triggered by oral diabetes medications that cause the pancreas to produce more insulin. Whatever the cause of the seizure, it needs to be treated as a medical emergency. To identify the onset of a hypoglycemic seizure, look for the following warning signs of seizures and symptoms: Sweating Confusion Feeling faint or too sleepy Feeling cold or clammy Hallucinations Unexplained emotional behaviors Uncontrollable crying Unaware of surroundings Changes in vision Loss of ability to speak clearly Loss of muscle control Muscle weakness Anxiety So what happens during a seizure? If a diabetic seizure is untreated you may become unconscious, f Continue reading >>
Hypoglycemia, Functional Brain Failure, And Brain Death
Hypoglycemia, including iatrogenic hypoglycemia in people with diabetes, causes brain fuel deprivation that initially triggers a series of physiological and behavioral defenses but if unchecked results in functional brain failure that is typically corrected after the plasma glucose concentration is raised. Rarely, profound, and at least in primates prolonged, hypoglycemia causes brain death. Given the survival value of maintaining physiological plasma glucose concentrations, it is not surprising that mechanisms that normally very effectively prevent or rapidly correct symptomatic hypoglycemia have evolved (1). As a result, hypoglycemia is a distinctly uncommon clinical event except in people who use drugs that lower the plasma glucose concentration (2). Although there are other drugs, and several relatively uncommon conditions, that cause hypoglycemia (2), in the vast majority of instances the offending drug is an insulin secretagogue or insulin used to treat diabetes mellitus (2, 3). As a result of the interplay of relative or absolute therapeutic insulin excess and compromised physiological and behavioral defenses against falling plasma glucose concentrations, hypoglycemia is the limiting factor in the glycemic management of diabetes (3). It causes recurrent morbidity in most people with type 1 diabetes mellitus (T1DM) and in many with advanced T2DM and is sometimes fatal. Furthermore, hypoglycemia, as well as prior exercise and sleep, further compromise glycemic defenses by causing hypoglycemia-associated autonomic failure and thus a vicious cycle of recurrent hypoglycemia. Finally, the barrier of hypoglycemia precludes maintenance of euglycemia over a lifetime of diabetes and thus full realization of the long-term vascular benefits of glycemic control. Go to: Functi Continue reading >>
Diabetic ketoacidosis and hyperosmolar hyperglycemic state have the same cause: insufficient insulin. There are two types of hyperglycemic emergencies: diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). These situations require emergency medical intervention, since they can lead to serious conditions such as coma, even death, if left untreated. Diabetic ketoacidosis and hyperosmolar hyperglycemic state have the same cause: insufficient insulin. These complications can arise in specific situations, during sick days, for example. Diabetic ketoacidosis Diabetic ketoacidosis mainly occurs in people with type 1 diabetes. It is characterized by hyperglycemia often greater than 20 mmol/L, with the presence of ketones in the blood or urine. Ketones are produced from the breakdown of fats. Their accumulation in the blood is toxic for the body. This situation arises when the body lacks insulin and must use its fat reserves for the energy it normally gets from glucose. Diabetic ketoacidosis can arise due to a forgotten or skipped insulin dose, an improper adjustment to the insulin dose, an insulin pump that stops working, or a serious medical problem (e.g., heart attack, pneumonia). The following symptoms are associated with diabetic ketoacidosis: deep, rapid breathing nausea, vomiting abdominal pain decreased consciousness, confusion, agitation, unusual behaviour Hyperosmolar hyperglycemic state Hyperosmolar hyperglycemic state occurs primarily in people with type 2 diabetes. This state is characterized by hyperglycemia often greater than 30 mmol/L, and severe dehydration. During a hyperglycemic episode, the accumulation of glucose in the blood increases the frequency and volume of urination. This can cause excessive water loss and significant dehydration. Th Continue reading >>
Type 2 Diabetes And Hypoglycemia (low Blood Sugar/insulin Shock)
People with type 2 diabetes are especially at risk for hypoglycemia, which is also called low blood sugar or insulin shock. Hypoglycemia develops if blood glucose levels fall below normal. This may be caused by insufficient intake of food, too much exercise or excessive alcohol intake. One of the most common causes of hypoglycemia is injecting too much insulin. People with diabetes who inject insulin are at high risk of developing hypoglycemia. But anyone with diabetes using hypoglycemic (blood sugar lowering) medications needs to watch for signs of hypoglycemia. Usually the condition is manageable, though occasionally it can be severe or even life-threatening, particularly if the victim fails to recognize the symptoms. Managing diabetes as effectively as possible to increase insulin sensitivity can greatly reduce the risk of hypoglycemia. It is also essential to manage exercise and food intake responsibly, as directed by your doctor. Mild hypoglycemia is common among people with type 2 diabetes. Severe episodes are rare, even among those who are taking insulin. However, everyone who is controlling glucose levels should be aware of warning symptoms. Persons with diabetes at highest risk for severe hypoglycemia are those who have a previous history of the disorder or those who develop "hypoglycemia unawareness." (1) This latter condition occurs when people become insensitive to hypoglycemic symptoms. In such cases, hypoglycemia appears without warning, and can escalate to a severe level. Even a single recent episode of hypoglycemia may make it more difficult to detect the next episode. But with vigilant monitoring and by rigorously avoiding low blood glucose levels, people with diabetes can often regain the ability to sense the symptoms. It is important to note that even Continue reading >>
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Pets With Diabetes: Hypoglycemia
Signs Treatment Asymptomatic Hypo Be Prepared (how to carry a sugar supply) Exercise and hypo. Nigel Goes Hypo Hypo Humor References The most serious side effect of too much insulin is hypoglycemia, or low blood glucose. Hypoglycemia can be a life-threatening, even fatal condition. Classic signs of hypoglycemia lethargy (lack of energy) weakness head tilting "drunkedness" - wobbling when walking, unbalanced hunger restlessness shivering ataxia - usually lack of muscular coordination, but maybe changes in head and neck movements disorientation stupor convulsions or seizures coma The occurrence of signs depends on how far the bg drops and on how fast the blood glucose drops. Owners of diabetic cats have also reported observing these signs sleepiness unable to wake the cat easily when it is sleeping. vomiting glassy eyes - it may look like it is staring into space laying, sleeping, or curled up in an unusual location of the house meowing, crying, yowling, or vocalizing in a way that is unusual for your cat some cats get aggressive drooling coughing Owners of diabetic dogs have also reported observing these signs sweating - check the nose and the paw pads. lip smacking or licking getting physically "stuck" in a place where the pet normally could get itself out (for example, behind a partially closed door that a pet would usually nudge open.) Some animals are asymptomatic at very low bg values. This means they do not show any of the usual signs of hypoglycemia even though their bg is very low. Read experiences of three pets who have had episodes of asymptomatic hypoglycemia. Be Prepared Always have corn syrup or sugar available. Corn syrup works well because it is a very pure sugar, and it is liquid. In the U.S. "Karo" is a brand name of corn syrup and you'll often see this Continue reading >>
Diabetic hypoglycemia is a low blood glucose level occurring in a person with diabetes mellitus. It is one of the most common types of hypoglycemia seen in emergency departments and hospitals. According to the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP), and based on a sample examined between 2004 and 2005, an estimated 55,819 cases (8.0% of total admissions) involved insulin, and severe hypoglycemia is likely the single most common event. In general, hypoglycemia occurs when a treatment to lower the elevated blood glucose of diabetes inaccurately matches the body's physiological need, and therefore causes the glucose to fall to a below-normal level. Definition A commonly used "number" to define the lower limit of normal glucose is 70 mg/dl (3.9 mmol/l), though in someone with diabetes, hypoglycemic symptoms can sometimes occur at higher glucose levels, or may fail to occur at lower. Some textbooks for nursing and pre-hospital care use the range 80 mg/dl to 120 mg/dl (4.4 mmol/l to 6.7 mmol/l). This variability is further compounded by the imprecision of glucose meter measurements at low levels, or the ability of glucose levels to change rapidly. Signs and symptoms Diabetic hypoglycemia can be mild, recognized easily by the patient, and reversed with a small amount of carbohydrates eaten or drunk, or it may be severe enough to cause unconsciousness requiring intravenous dextrose or an injection of glucagon. Severe hypoglycemic unconsciousness is one form of diabetic coma. A common medical definition of severe hypoglycemia is "hypoglycemia severe enough that the person needs assistance in dealing with it". A co-morbidity is the issue of hypoglycemia unawareness. Recent research using machine learning methods have proved to Continue reading >>
What Is The Difference Between Hyperglycemia And Hypoglycemia?
By Debra A. Sokol-McKay, MS, CVRT, CDE, CLVT, OTR/L, SCLV What Is Hyperglycemia? In relation to diabetes, hyperglycemia refers to chronically high blood glucose levels. Most medical professionals define hyperglycemia by using the blood glucose goals that you and your physician have established and combining those goals with the blood glucose target ranges set by the American Diabetes Association. It's important to understand that you'll probably experience high blood glucose levels from time to time, despite your best efforts at control. As with any chronic disease, talk with your physician and diabetes care team if the pattern of your blood glucose readings is consistently higher or lower than your blood glucose goals. Complications from Hyperglycemia Persistent hyperglycemia can cause a wide range of chronic complications that affect almost every system in your body. When large blood vessels are affected, it can lead to: Stroke (cerebral vascular disease) Heart attack or Congestive Heart Failure (coronary heart disease) Circulation disorders and possible amputation (peripheral vascular disease) When smaller blood vessels are affected, it can lead to: Kidney disease (nephropathy) Nerve damage (neuropathy) Diabetic eye disease (retinopathy) Joseph Monks: Writer, Producer, and Film Director Joseph Monks, who has diabetic retinopathy, creates and produces films for his production company Sight Unseen Pictures. He is also the first blind filmmaker to direct a feature film. Says Joe, "I'm not uncomfortable with the term 'blind.' I'm not thrilled about it, of course, but it's accurate. The lights went out for me in early 2002 as a result of diabetic retinopathy—the death of my retinas. It is what it is, so when it happened, I decided that I wasn't going to let it put an en Continue reading >>
A Silent Danger: When Blood Sugar Goes Down While You Were Sleeping
You've heard it before—how taking a snack at nighttime after dinner may not be such a good idea, what with the weight gain that may come with it. But if you're a diabetic, that nighttime snack may spell the difference between life and death—literally. “The absence of a nighttime snack when one is usually taken is one cause of nocturnal hypoglycemia,” said Dr. Richard Elwyn Fernando, president of Diabetes Philippines and consultant at St. Luke's Medical Center and Capitol Medical Center. Nocturnal hypoglycemia, as the name implies, happens at night. “It occurs when blood glucose levels fall below 4 millimoles per liter (mmol/l) or 72 milligrams per deciliter (mg/dl). At 40 mg/dl or below, a person can be comatose... In rare cases, it may lead to death,” Fernando said during a media briefing organized by pharmaceutical company Novo Nordisk last May 27. What makes it dangerous is that the person, being asleep, is not aware of what is happening and is not able to seek help. This poses a real concern for diabetics and their families, said Fernando. In a previous interview, former Health Secretary Esperanza Cabral said the body needs glucose to function well. “Kailangan ng katawan ang sugar for energy, metabolism,” she told GMA News. When the blood sugar drops to low levels, a person may experience dizziness, weakness and even fainting, Cabral said. There may also be confusion and disorientation. Fernando said hypoglycemia may lead to complications affecting the heart (decreased heart rate, decreased cardiac output, myocardial contractility), blood vessels (stroke, myocardial infarction, acute cardiac failure, ventricular arrythmia), and brain (seizures, convulsions, coma). While hypoglycemia may occur in both diabetics and non-diabetics alike—“kapag gutom Continue reading >>
What is non-diabetic hypoglycemia? Hypoglycemia is the condition when your blood glucose (sugar) levels are too low. It happens to people with diabetes when they have a mismatch of medicine, food, and/or exercise. Non-diabetic hypoglycemia, a rare condition, is low blood glucose in people who do not have diabetes. There are two kinds of non-diabetic hypoglycemia: Reactive hypoglycemia, which happens within a few hours of eating a meal Fasting hypoglycemia, which may be related to a disease Glucose is the main source of energy for your body and brain. It comes from what we eat and drink. Insulin, a hormone, helps keep blood glucose at normal levels so your body can work properly. Insulin’s job is to help glucose enter your cells where it’s used for energy. If your glucose level is too low, you might not feel well. What causes non-diabetic hypoglycemia? The two kinds of non-diabetic hypoglycemia have different causes. Researchers are still studying the causes of reactive hypoglycemia. They know, however, that it comes from having too much insulin in the blood, leading to low blood glucose levels. Types of nondiabetic hypoglycemia Reactive hypoglycemia Having pre-diabetes or being at risk for diabetes, which can lead to trouble making the right amount of insulin Stomach surgery, which can make food pass too quickly into your small intestine Rare enzyme deficiencies that make it hard for your body to break down food Fasting hypoglycemia Medicines, such as salicylates (such as aspirin), sulfa drugs (an antibiotic), pentamidine (to treat a serious kind of pneumonia), quinine (to treat malaria) Alcohol, especially with binge drinking Serious illnesses, such as those affecting the liver, heart, or kidneys Low levels of certain hormones, such as cortisol, growth hormone, glu Continue reading >>
Can You Have Low Blood Sugar With Type 2 Diabetes?
back to Overview Know-how Type 2 A tag-team approach on low blood sugar with type 2 diabetes. Markus recently wrote an article on our German language blog talking about low blood sugar with type 2 diabetes. The question (“can I have low blood sugar with type 2 diabetes?”) is very common, and it’s easy to see why it’s of concern. So I’ve helped Markus bring his German post to life here in English. I hope it helps! Here’s Markus: Low blood sugar In 2014, results from the DAWN2 study were announced. It was the largest study of its kind (15,000 participants) on the “fears & needs of people with diabetes and their families.” One result stood out: The gravest fears are related to low blood sugars, especially at night. Up to 69% of the participants share this fear! So! Can you have low blood sugar with type 2 diabetes? Yes! Of course! But let’s think about who exactly is at risk – and why. It’s common to think: Type 1 diabetes = at risk for lows Type 2 diabetes = not at risk for lows But that isn’t correct at all, so we should wipe it from our mind. So… what do I need to know? Maybe it’s more accurate to say that people with type 2 diabetes who take certain types of medication are more at risk for lows. We’re getting closer! But to get to the truth, we should take a look at someone without diabetes. Is it possible for them to have lows, too? Theoretically yes, especially if doing long-lasting physical activities without proper food intake. Additionally, extreme stress and binge drinking are also common causes of low blood sugar for people without diabetes. However, it’s pretty rare because as soon as BG’s drop below 80 mg/dl (4.4 mmol/L), the natural counterregulatory system kicks in, raising blood sugar back to normal levels. I’ve never exp Continue reading >>
Dealing With Hypoglycemia
If you have diabetes, your concern isn’t always that your blood sugar is too high. Your blood sugar can also dip too low, a condition known as hypoglycemia. This occurs when your blood sugar levels fall below 70 milligrams per deciliter (mg/dl). The only clinical way to detect hypoglycemia is to test your blood sugar. However, without blood tests it’s still possible to identify low blood sugar by its symptoms. Early recognition of these symptoms is critical because hypoglycemia can cause seizures or induce a coma if left untreated. If you have a history of low blood sugar episodes, you may not feel symptoms. This is known as hypoglycemic unawareness. By learning to control your blood sugar, you can prevent hypoglycemic episodes. You also should take steps to ensure you and others know how to treat low blood sugar. Managing your blood sugar is a constant balancing of: diet exercise medications A number of diabetes medications are associated with causing hypoglycemia. Only those medications that increase insulin production increase the risk for hypoglycemia. Medications that can cause hypoglycemia include: Combination pills that contain one of the medications above may also cause hypoglycemic episodes. This is a reason why it’s so important to test your blood sugar, especially when making changes to your treatment plan. Some of the most common causes of low blood sugar are: skipping a meal or eating less than usual exercising more than usual taking more medication than usual drinking alcohol, especially without food People with diabetes aren’t the only ones who experience low blood sugar. If you have any of the following conditions, you may also experience hypoglycemia: weight-loss surgery severe infection thyroid or cortisol hormone deficiency Hypoglycemia affect Continue reading >>