Diabetes Management: Medications, Education, and Hypoglycemia
Other Diabetes Medications
Other diabetes drugs include short-acting secretagogues for postprandial hyperglycemia, alpha-glucosidase inhibitors to decrease and delay intestinal glucose absorption, PPAR agonists to reduce tissue resistance to insulin, and anti-obesity drugs.
Diabetes Education
Diabetes education is a teaching-learning process where patients gain knowledge, skills, and positive attitudes to promote healthy behaviors. This helps avoid acute complications, prevent or delay chronic complications, and maintain autonomy in their treatment.
Appropriate Education Modalities
- Single Education: Crucial at diagnosis for immediate therapeutic changes and daily reinforcements.
- Group Education: Groups of 8-10 patients allow for experience sharing and encouragement.
Educational Program Components
Knowledge:
- General information about the disease
- Emergencies
- Long-term complications
- Diet and exercise
- Nutrition
- Hygiene
- Self-monitoring of blood glucose
- Insulin and oral agents
- Self-help associations
Skills:
- Self-analysis
- Insulin self-injection
- Using a reflectometer
- Diet planning
Attitudes:
- Acceptance of illness
- Adaptation to changes
- Self-responsibility
- Collaboration with healthcare providers
Hypoglycemia
Hypoglycemia is a common and potentially serious complication in diabetes.
Definition
Hypoglycemia is defined as an acute decrease in plasma glucose below the normal lower limit (70-100 mg/dL). It is an acute metabolic complication accompanied by specific clinical symptoms that disappear when glucose levels are restored.
Symptoms of Hypoglycemia
Catecholamine Effects:
- Hunger
- Sweating
- Tachycardia
- Increased salivation
- Weakness
- Blurred vision
- Anxiety
- Tremor
- Bad mood
Central Nervous System Effects:
- Headache
- Behavior change
- Language disorders
- Decreased consciousness
- Delirium
- Confusion
- Ataxia
- Coma
- Hallucinations
- Aggressiveness
Causes of Hypoglycemia
- Excess insulin or oral hypoglycemic agent (OHA) administration
- Decreased food intake
- Increased exercise
- Delayed food intake after insulin administration
- Faulty insulin injection technique
- Injection site changes
- Exercise or heat in the injection area
- Drugs that potentiate insulin or OHA action
- Kidney failure
- Excessive alcohol intake
Treatment of Hypoglycemia
Mild Hypoglycemia:
Oral route is used in two phases:
- Consume 10 grams of carbohydrates (fruit juice, candy, or 1-2 sugar lumps).
- Wait 10 minutes; if symptoms persist, repeat carbohydrate intake.
- Once recovered, consume complex carbohydrates or eat the next meal.
Severe Hypoglycemia:
If consciousness is impaired, do not use the oral route. Place the patient on their side to keep the airway open and administer 1 mg of Glucagon IM or SC. Take the patient to a health center for intravenous glucose administration. If consciousness is regained, continue treating mild hypoglycemia until complete recovery. In patients with alcohol intoxication, glucagon may not be effective.