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On one occasion she took an insulin injection just prior to eating dinner. Then immediately got sick with the flu and starting vomiting before she could eat.
By the time I got home she was in insulin shock and was unable to respond. I gave her an injection of glucose and took her to the emergency room. She was in the hospital for a couple of days.
Emergency glucose injection kit.
On driving home from work one day she continued to drive by the proper turn to get home. Luckily I just happened to be following her. My honking to get her attention had no effect, when she did stop at a stop sign I was able to pull in front of her to keep her from going on. She was having a hypoglycemic episode and did not know where she was.
There was an incident several years ago where a diabetic patient drove some 15 to 20 miles out of her way trying to go home and actually caused a head-on accident killing an individual.
Be sure your diabetic patients are not having a low blood glucose level when leaving your office.
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Physical signs:
- Sweating
- Shaky behavior
- In severe cases seizures and becoming unconscious
Cognitive signs:
- Not be able to concentrate
- Not being to think through things
- Not being able to follow directions
- Reading something but not being able to comprehend
Emotional signs:
- quick to anger
- having an attitude
- denial that there is anything wrong
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Many long standing diabetics get to the place where they can not always tell when they have low blood glucose levels. You should have orange juice or glucose available.
I would suggest that all offices should also have a glucometer available.
Referring patients to diabetic educators can also be very helpful to the patients.
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Course Certification Examination
Go to: [Complicated Diabetic Patient CE table of contents] [Online CE main page]
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