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Hypoglycemia Prevention and Treatment PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Hypoglycemia Prevention & Treatment"by Dr Swaapnika.

This medical PowerPoint presentation talks about hypoglycemia, a condition in which your blood sugar levels drop too low, causing symptoms such as weakness, shakiness, confusion, and sweating. It is most commonly seen in people with diabetes, although it can also occur in people without diabetes. This presentation lists some tips for preventing and treating hypoglycemia.

Tags : hypoglycemia, endocrinology, endocrinology PowerPoint presentation

Published on : Apr 18, 2023 | Views : 615 | Downloads : 2

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Slide 1-

Hypoglycemia Prevention & Treatment Gary Scheiner MS, CDE Owner, Integrated Diabetes Services 333 E. Lancaster Ave., Suite 204 Wynnewood, PA 19096 877-SELF-MGT (735-3648) (610) 642-6055 www.integrateddiabetes.com Gary@integrateddiabetes.com
Slide 2-

Hypoglycemia:Definitions “Mild”: Adrenergic (BG<70) (<4mmol) “Moderate”: Cognitive (BG<50) (<3mmol) “Severe”: Unconscious (BG ???)
Slide 3-

Hypoglycemia:Cause Imbalance between factors raising and lowering blood glucose levels
Slide 4-

Hypoglycemia “The Greatest Limiting Factor In Diabetes Management”
Slide 5-

The Great Limiting Factor Performance Impairment
Slide 6-

The Great Limiting Factor Accident Risk
Slide 7-

The Great Limiting Factor Anxiety / Embarrassment
Slide 8-

The Great Limiting Factor Lasting Damage?  Spatial memory / performance (if before age 5)
Slide 9-

The Great Limiting Factor Diminished Symptoms (Hypoglycemic Unawareness)
Slide 10-

The Great Limiting Factor Rebound
Slide 11-

The Great Limiting Factor Weight Gain
Slide 12-

Hypoglycemia:Targets/Goals Unable to recognize & verbalize lows: >80 (4.5 mmol) Able to recognize & verbalize lows: >70 (4 mmol) Pregnancy: >60 (3.3 mmol) <10% of readings below target at each time of day No severe lows
Slide 13-

Hypoglycemia Prevention Strategies 1. Insulin Program Setup (background/basal)
Slide 14-

Hypoglycemia Prevention Strategies 1. Insulin Program Setup (background/basal)
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Hypoglycemia Prevention Strategies 1. Insulin Program Setup (background/basal)
Slide 16-

Hypoglycemia Prevention Strategies 1. Insulin Program Setup (background/basal)
Slide 17-

Hypoglycemia Prevention Strategies 1. Insulin Program Setup (background/basal) Basal insulin should hold BG STEADY in the absence of food, exercise and bolus insulin!
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Hypoglycemia Prevention Strategies 1b. Insulin Program Setup (Meal/Bolus) Only rapid analogs work when needed – right after eating!
Slide 19-

Hypoglycemia Prevention Strategies 2. Meal/Snack Timing Major issue w/a.m. NPH/Lente Minor issue w/Lantus or Levemir Not usually an issue with pump use
Slide 20-

Hypoglycemia Prevention Strategies 1500-Rule (aggressive) (83 rule) 1800-Rule (conservative) (100 rule) (Total Daily Ins.)/1500 or 1800 May vary day vs. night (nighttime often 50% more than day) 3a. Proper Correction Doses
Slide 21-

Hypoglycemia Prevention Strategies Premeal: 100 (5.5) (aggressive) 120 (6.7) (typical) 140-150 (7.6-8.3) (cautious) 3b. Appropriate BG Targets Postmeal (1-2 hrs): <160 (9) (aggressive) <180 (10) (typical) < 200 (11) (cautious)
Slide 22-

Hypoglycemia Prevention Strategies I:C Ratio that matches pre-meal BG 3-4 hours (not 2!) after eating I:C Ratio often varies from meal to meal (bkfst dose > lunch & dinner) 4. Proper Meal/Bolus Doses
Slide 23-

Hypoglycemia Prevention Strategies 5. Account For “Unused” Insulin* * Newer pumps figure this automatically based on the insulin duration you set.
Slide 24-

Hypoglycemia Prevention Strategies 5. Account For “Unused” Insulin Example: Gave 6.0 units at 7pm, BG 200 at 9pm. Conservative approach: 40% remaining (6 x .4) = 2.4 units left Aggressive approach: 33% remaining (6 x .33) = 2 units left Subtract the unused insulin from your usual correction dose!
Slide 25-

Hypoglycemia Prevention Strategies 6. Carb Counting Accuracy Proper Portion Measurement Look Up Unknown / Restaurant Foods Use Carb Factors Subtract 100% of Fiber Subtract 50% of Sugar Alcohols
Slide 26-

Hypoglycemia Prevention Strategies 7. Extend Meal Insulin When Necessary Use When: Portions are very large Meal is prolonged Food is low-glycemic index (pasta, legumes, dairy…) Apply Via: Square/Dual/Extended/Combo bolus on pump Delayed or Split bolus on injections
Slide 27-

Hypoglycemia Prevention Strategies 8. Adjustment for Physical Activity Exercise, recreation, chores: all count! Reduce meal insulin (25%, 33%, 50%) for after-meal activity Snack prior to before/between meal activity Lower long-acting/basal insulin during and after prolonged activity
Slide 28-

Hypoglycemia Prevention Strategies 8. Watch Out for D’OH! (Delayed Onset Hypoglycemia) Following High-Intensity Exercise Following Extended Duration Activity May Occur Up to 24 Hours After Adjustments to food/insulin after activity: lower basal insulin for 8-12 hours low-G.I. Snacks lower mealtime boluses
Slide 29-

Hypoglycemia Prevention Strategies 9. Adjustment for Alcohol Alcohol reduces the liver’s output of glucose and masks hypoglycemic symptoms Delayed BG drops can occur Decrease basal insulin (or overnight long-acting insulin) after drinking
Slide 30-

Hypoglycemia Prevention Strategies 10. Consistent Monitoring Before All Meals & Snacks Pre/Post Exercise Bedtime 3 a.m. (occasionally)
Slide 31-

Hypoglycemia Prevention Strategies 11. Recording & Analysis Record all pertinent data BGs Carb Activity Insulin Use an organized form (multiple days on single page, if possible)
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Hypoglycemia Prevention Strategies 11. Recording & Analysis Review every 7-10 days Look for patterns > 10% below target range @ given time Lows during/post-activity Lows on School/Work vs. off-day Lows Post-Menstrual
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Hypoglycemia Prevention Strategies 12. Continuous Glucose Monitoring Alarms to alert user/family of pending lows
Slide 35-

Hypoglycemia Prevention Strategies 12. Continuous Glucose Monitoring
Slide 36-

Hypoglycemia Treatment Mild/Moderate Low Check BG First Treat w/High-Glycemic Index Food Treat w/Proper Amount Re-Check in 15 Minutes High-GI Foods Glucose Tablets Dry Cereal Pretzels Graham Crackers Vanilla Wafers Jelly Beans Gatorade
Slide 37-

Hypoglycemia Treatment Use of Glycemic Index Lower GI foods digest & convert to glucose more slowly High-fiber slower than low Hi-fat slower than low Solids slower than liquids Cold foods slower than hot Type of sugar/starch affects GI
Slide 38-

Use of Glycemic Index (contd) Hypoglycemia Treatment
Slide 39-

Hypoglycemia Treatment Always Carry Rapid-Acting Carbs!
Slide 40-

Hypoglycemia Treatment DEXTROSE Rules! Glucose Tablets Sweet Tarts Smarties Spree Air Heads
Slide 41-

Hypoglycemia Treatment Once BG has risen, give rapid-acting insulin to cover any overtreatment!
Slide 42-

Hypoglycemia Treatment Treatment amt. for insulin on board Treatment amt. for recent exercise Treatment amt. for previous low-G.I. foods “Idiosyncracies”
Slide 43-

Hypoglycemia Treatment Severe Low Unconscious / Unresponsive Seizure Uncooperative
Slide 44-

Take-Home Messages Quantify Your Lows Strategize to Minimize Plan for Proper Treatment
Slide 45-

The Source of My Highs and Lows