1. Abnormal Conditions

2.  Overactive thyroid – too much thyroxin is produced  Thyroid becomes enlarged  S&S ◦ Increase appetite with weight loss ◦ Fast growing ◦ Rough fingernails ◦ Weakened muscles ◦ Increase BP / Perspiration / Irritability ◦ Hand tremors ◦ Liver releases excessive glucose into the bloodstream  Tx ◦ Medication to reduce thyroxin production / Removal of thyroid gland

3.  Insufficient secretion of thyroxin / Can be caused by iodine deficiency  Tx is determined by cause  S&S ◦ Fatigue ◦ Constipation ◦ Dry skin ◦ Unexplained weight gain ◦ Muscle weakness ◦ Pain, stiffness or swelling in your joints ◦ Thinning hair ◦ Depression ◦ Impaired memory

4.  Decrease secretion of insulin  Insulin aids in the use of glucose as energy  2 main types: Type I and Type II  Normal BS levels ◦ Fasting (less than 100; 70-80) ◦ After meals (less than 140)

5.  Juvenile Diabetes (Children & young adults)  Pancreas does not secrete insulin  S&S ◦ Polyuria ◦ Polydypsia ◦ Weight loss ◦ Blurred vision ◦ Diabetic coma  Tx ◦ Insulin ◦ Daily monitoring of blood sugar

6.  Adult onset Diabetes  Body resists the effective use of insulin  Common is 45 yrs. old and older (overweight)  Increase in children developing Type II diabetes  S&S ◦ Fatigue ◦ Frequent urination (especially at night) ◦ Unusual thirst ◦ Frequent infections / Slow healing time  Tx ◦ Healthy diet / Exercise ◦ Insulin (prn)

7.  Muscles become starved for energy (glucose)  Body will breakdown fat – creating toxins (ketones)  Occurs with Type I – with BS 240 or higher  Test urine for presence of ketones  Can lead to a diabetic coma  Tx – IV insulin / IV fluids  S&S ◦ Fruity breath ◦ Pain in the abdomen ◦ Difficulty breathing ◦ Tired / Confused ◦ N/V

8.  Very low schedule (Insulin-sensitive)Insulin ◦ BG 150-199: 0.5 unit bolus Insulin (regular or rapid-acting)Insulin ◦ BG 200-249: 1 units bolus InsulinInsulin ◦ BG 250-299: 1.5 units bolus InsulinInsulin ◦ BG 300-349: 2 units bolus InsulinInsulin ◦ BG Over 350: 2.5 units bolus InsulinInsulin  Low schedule ◦ BG 150-199: 1 unit bolus Insulin (regular or rapid-acting)Insulin ◦ BG 200-249: 2 units bolus InsulinInsulin ◦ BG 250-299: 3 units bolus InsulinInsulin ◦ BG 300-349: 4 units bolus InsulinInsulin ◦ BG Over 350: 5 units bolus InsulinInsulin  Medium schedule ◦ BG 150-199: 1 unit bolus Insulin (regular or rapid-acting)Insulin ◦ BG 200-249: 3 units bolus InsulinInsulin ◦ BG 250-299: 5 units bolus InsulinInsulin ◦ BG 300-349: 7 units bolus InsulinInsulin ◦ BG Over 350: 8 units bolus InsulinInsulin  High schedule (Insulin-resistant)Insulin ◦ BG 150-199: 2 unit bolus Insulin (regular or rapid-acting)Insulin ◦ BG 200-249: 4 units bolus InsulinInsulin ◦ BG 250-299: 7 units bolus InsulinInsulin ◦ BG 300-349: 10 units bolus InsulinInsulin ◦ BG Over 350: 12 units bolus InsulinInsulin