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Usually, people are recommended to control diet, exercise, and maintain a healthy weight, although some people may need medications to control their blood sugar levels. Other goals of diabetes management are to prevent or treat complications that can result from the disease itself and from its treatment. [3]
It is classically a nursing home condition but can occur in all ages. The diagnosis is usually discovered when a chemistry screen performed because of obtundation reveals an extremely high blood sugar level (often above 1800 mg/dl (100 mM)) and dehydration. The treatment consists of insulin and gradual rehydration with intravenous fluids.
In about 10% of cases the blood sugar is not significantly elevated ("euglycemic diabetic ketoacidosis"). [3] A pH measurement is performed to detect acidosis. Blood from a vein is adequate, as there is little difference between the arterial and the venous pH; arterial samples are only required if there are concerns about oxygen levels. [6]
The complications of diabetes can dramatically impair quality of life and cause long-lasting disability. Overall, complications are far less common and less severe in people with well-controlled blood sugar levels. [3] [4] [5] Some non-modifiable risk factors such as age at diabetes onset, type of diabetes, gender, and genetics may influence risk.
Hyperosmolar hyperglycemic state (HHS), also known as hyperosmolar non-ketotic state (HONK), is a complication of diabetes mellitus in which high blood sugar results in high osmolarity without significant ketoacidosis. [4] [5] Symptoms include signs of dehydration, weakness, leg cramps, vision problems, and an altered level of consciousness. [2]
In type 1 diabetes, there is a lower total level of insulin to control blood glucose, due to an autoimmune-induced loss of insulin-producing beta cells in the pancreas. [12] [13] Diagnosis of diabetes is by blood tests such as fasting plasma glucose, oral glucose tolerance test, or glycated hemoglobin (A1c). [3]
Like type 1 and type 2 diabetes, gestational diabetes causes blood sugar levels to become too high. It involves an increased risk of developing diabetes for both mother and child. Other types of diabetes: Congenital diabetes – Cystic fibrosis-related diabetes – Steroid diabetes – Monogenic diabetes –
In fasting adults, blood plasma glucose should not exceed 7 mmol/L or 126 mg/dL. Sustained higher levels of blood sugar cause damage to the blood vessels and to the organs they supply, leading to the complications of diabetes. [48] Chronic hyperglycemia can be measured via the HbA1c test. The definition of acute hyperglycemia varies by study ...