Module 8: Acute complications

There are two common acute complications of diabetes: hypoglycemia and hyperglycaemia. Both are serious and can lead to death so emergency treatment is required. The emphasis in this module is on teaching people with diabetes about the causes as well as how to prevent, recognize and treat these complications.

Objectives - Hypoglycemia

You have completed this module when you are able to:

• Define hypoglycemia;
• Recognize the effect of fear in relation to hypoglycemia;
• Identify the causes of hypoglycemia;
• Identify the symptoms of hypoglycemia;
• Identify ways to prevent hypoglycemia;
• Explain the treatment for hypoglycemia;
• Explain how to use glucagon in the treatment of hypoglycemia; and
• Describe one method for managing hypoglycemia unawareness.

Objectives - Hyperglycemia

You have completed this module when you are able to:

• Identify the causes of diabetic ketoacidosis (DKA);
• Describe the signs and symptoms of DKA;
• Identify how to prevent DKA;
• Explain how DKA is treated;
• Describe people most at risk of developing hyperglycemic hyperosmolar state (HHS);
• Explain preventive strategies for HHS;
• Describe the signs and symptoms of HHS;
• Explain how HHS is treated; and
• Identify the mortality rate for HHS.

Objectives - Management of illness at home

You have completed this module when you are able to:

• Explain the importance of insulin administration for people with diabetes during times of concurrent illness;
• Describe the use of blood glucose and ketone testing during a period of illness;
• Explain insulin adjustment during times of concurrent illness;
• Discuss strategies to help people obtain sufficient carbohydrate intake during times of illness; and
• Describe when medical or hospital intervention is necessary.

To enhance your learning, you may also wish to refer to the "Hypo and hyperglycemic emergencies in adults" section of the Canadian Pharmacists Journal's supplement on Diabetes. (CPJ 2009;142[SUPPL 1])