Diabetes Type 1 (“Juvenile Diabetes”) (“Insulin-Dependant Diabetes”)

Pathophysiology Autoimmune disease Destroys beta cells in Islets of Langerhans Sufficiently reduces and eventually completely eliminates insulin production

Cause: Unknown –Genetics plays a strong role –May also be triggered by environmental factors –NOT from eating too many sweets

Presentation Thirst and frequent urination Extreme hunger Weight loss Fatigue Blurred vision Dry itchy skin that heals slowly Loss of feeling or tingling in feet

Complications/ Associated Diseases Hypoglycemia: –Sweating –Shakiness –Weakness –Hunger –Dizziness –Nausea –Slurred speech –Drowsiness –Confusion –Seizures –Coma

Hypoglycemia Tx: –Administer Glucagon (1mg IM SQ) –Administer D50 (25-50 g IV) –If awake and able to swallow/protect airway: Fruit juice Milk Hard candy Glucose tablets Granulated white sugar Regular non-diet soda Follow with high protein snack

DO NOT: –Put sugar in an unconscious pt’s mouth –Try pouring juice or sugar water down an unconscious pt’s throat –Administer Insulin –Administer Peanut butter –Put your hand in the pt’s mouth Random trivia: Animals get diabetes too!

Diabetic Ketoacidosis –Slow onset –Dry mouth/ thirst –High blood glucose levels –High ketone levels in urine –Constant fatigue –Dry, flushed skin –Nausea, vomiting, abdominal pain –Difficulty breathing/ Kuussmaul’s –Fruity odor on breath –Difficulty concentrating/confusion

Diabetic Ketoacidosis Tx: –IV fluid replacement –If pt is known alcoholic consider 100mg Thiamine –If transportation time is lengthy medical direction may request insulin administration

Hyperglycemia (CBG>250mg/dl) Nephropathy (kidney disease) Eye/Skin/Foot complications Depression Gastroparesis Heart disease Stroke Neuropathy/Nerve damage Celiac Disease (severe reaction to gluten. 20% of diabetics affected)

Tx/Management/Cures Diet control exercise Insulin shots/Insulin pumps Kidney transplantation Pancreas transplantation Islet transplantation Stem cell transplantation NO CURE YET

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biobliography American Diabetes Association. All about diabetes. Retrieved nov from Bledsoe, Porter, & Cherry. (2006). Paramedic Care: Principles and Practice. Upper Saddle River, NJ: Pearson Education Inc. Diabetes services Inc. (2007) diabetes mall: Diabetes Technology. Retrieved nov 25, 2007 from Hasselbring, B. What is Hypoglycemia?. Retrieved Nov 25, 2007 from hrome=c10&article=LC_90&center=p07 hrome=c10&article=LC_90&center=p07 Mayo Clinic Staff. (oct 24, 2007). Type 1 Diabetes. Retrieved nov 25, 2007 from diabeteshttp:// diabetes Medlineplus. (nov 23, 2007). Diabetes Type 1. Retrieved nov 25, 2007 from