With any disease or condition, awareness and education are crucial. That is why on Nov. 5, Ramapo students Jesse Valliere and Monika Weglarz from Alpha Phi Omega paired with registered nurse Ansara Persad from New Jersey Mobile Healthcare Training to host an informative presentation on diabetes, the seventh leading cause of deaths in the U.S.
Nurse Persad began by defining diabetes as “a group of metabolic diseases characterized by high blood sugar levels, which result from defects in insulin secretion, action, or both.” If a person lacks the proper levels of active insulin, their cells cannot metabolize glucose and obtain enough energy to function.
Type 1 and type 2 diabetes are both serious conditions that require lifelong management. Type 1 patients do not produce insulin, while type 2 patients produce amounts that do not function effectively. Treatment for type 1 centers on daily insulin injections, while treatment for type 2 may include diet and exercise because type 2 generally occurs later on in a patient’s life and is associated with obesity.
A modern way of managing type 1 diabetes involves pairing an insulin pump with an app that allows patients to see their blood sugar readings with their phones.
Technological advances are convenient, but it is still important to be able to manually identify signs of uncontrolled diabetes or a diabetic emergency. The three most common symptoms of uncontrolled diabetes are frequent urination, frequent drinking and excessive eating, also known as polyuria, polydipsia and polyphagia, respectively.
A diabetic emergency can occur when the body begins to break down fat cells due to a lack of available glucose, leading to diabetic ketoacidosis. Symptoms of DKA include weakness and nausea. A person experiencing DKA may seem drunk due to sweet-smelling breath, poor memory, and poor balance. Unless it’s rapidly identified and treated, DKA can lead to coma and death.
Although DKA is more common with type 1, it can occur in a patient with either type if they forget to eat after injecting insulin. “If they are alert enough to swallow or to talk, we give them glucose,” Persad explained in regards to treatment. Fruit juice and dextrose are two common sugar-rich substances used to quickly raise a person’s blood sugar.
A hyperglycemic crisis can occur when blood glucose levels are above the normal range of 80-120 mg/dL. This type of diabetic coma is caused by taking insufficient insulin, overeating, or being under the influence of alcohol, overexertion, or an illness. Treatment can take hours in a hospital setting. This crisis can be common at Thanksgiving if a diabetic patient forgets to adjust their insulin levels according to how much they will be eating.
Although it can happen with either kind, patients with type 2 diabetes are more prone to experiencing a hyperosmolar hyperglycemic nonketotic coma. Physical signs and symptoms include poor skin turgor, abdominal pain and lethargy. A lack of sweet-smelling breath is a key identifier to prevent it from being confused with DKA. It’s often treated with IV fluid in a hospital setting.
Other problems associated with diabetes include seizures and loss of airway management. It’s important for medical personnel to be aware of all issues potentially experienced by a diabetic patient and their respective treatments.
A majority of the presentation was geared toward the attendees from the nursing program. Persad covered the steps of assessing a patient to determine if they were experiencing a condition that mimics the symptoms of a diabetic episode, such as a stroke or head trauma. Checking a patient’s breathing and asking about their medical history are key.
A quick way to determine between hyperglycemia and hypoglycemia is by checking if the patient’s skin is dry and warm or moist and pale. A prominent sign of a hyperglycemic crisis is a rapid, weak pulse.
Overall, Persad gave an informative presentation with a powerpoint and selection of diagrams that were both eye-catching and educational. All that were in attendance, even those that are not nursing students or diabetic, are more prepared to identify a health crisis and ensure a person at risk receives the proper medical care.