Management of hypoglycemia Essay Example | Topics and Well Written Essays - 3000 words

Management of hypoglycemia - Essay Example Diabetes is increasingly common throughout the world.Its prevalence is well over 5% in many developed countries and is rising in the United Kingdom.While talking about its prevalence,it is to be remembered that diabetes is caused by our genes and our personal environment, which is created by our lifestyles. For people with diabetes, whether type 1 or type 2, the disorder can have a profound influence on all aspects of life and can affect most organs of the body. There is no cure for diabetes, and once occurs, it is present for life. The increasing appreciation throughout the healthcare industry for clinical decisions to be driven by sound scientific evidence represents an opportunity for the patients, practitioners, and healthcare planners alike in that it shapes the delivery of care on the basis of evidence of effectiveness. The past two decades have seen considerable progress in producing evidence to support treatments aimed at reducing the risk of diabetes and its complications. T his indicates a shift of focus from treatment of effects to treatment of cause, where prophylactic interventions are more important than just therapeutic measures. This means caregiving now does not await the disease to happen; rather, the care tends to identify population or individual who would develop diabetes in a later life (Foster, 1998, p 2069-2070).Definitions: Diabetes mellitus occurs either because of lack of insulin or because of the presence of factors that oppose the action of insulin. Therefore, it can be defined as a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas or by the ineffectiveness of the insulin that is produced. The result of insufficient action of insulin is an increase in blood glucose concentration or hyperglycaemia. This increased glucose would damage many of the body systems, most significantly blood vessels and nerves. Data from genetic, epidemiological, and aetiologic studies have led to the impr ovement of the understanding of the aetiology and pathogenesis of diabetes. From my experience in the clinical placement, I have come across patients during clinical practice with varied presentations. Whatever may be the mode of diagnosis, persistently elevated plasma glucose in the fasting state would lead to the diagnosis of diabetes mellitus even if the patient is asymptomatic. In the ward while working with the patients of diabetes, frequent monitoring of plasma glucose and adjusting the diet or medication is a normal routine nursing activity. I have see a venous plasma glucose concentration of 140 mg/dL in at least two separate occasions or plasma glucose concentration of 200 mg/dL 2 hours following ingestion of 75 g of glucose would constitute a diagnosis of diabetes mellitus(Foster, 1998, p 2080). Insulin: Diabetes is treated with insulin in the inpatients with or without oral hypoglycaemic agents. Since the disease at least partly results from insulin deficit, insulin is required for many patients with diabetes mellitus type 2. If no oral agents are used for treatment, all diet-responsive type 2 diabetics must be treated with insulin. My observation suggests that it is fairly easy to control the symptoms of diabetes with insulin, and as a nurse working in the ward, I know it is difficult to maintain a normal blood sugar throughout the day even with the use of multiple injections. It is also to be mentioned that the patient treated with insulin by injection cannot reproduce the physiologic changes in a normal patient in response to a diet load. Thus, if enough insulin is given to keep the postprandial glucose normal, too much insulin will be present during the postabsorptive phase, and hypoglycaemia will result. As a result, insulin therapy is guided mainly by adjustments