Diabetic question

D50 is 50%. An amp of D50 is 50mls of solution. 100% solution is 1g /ml. Therefore 50mls with 25g glucose is a 50% solution.
 
For me being an insulin dependant diabetic for >20 yrs. I always give my paiteients oj & food to raise their blood sugar if there CAO, but if they aren't completely with it (not unconscious yet)...i go for the oral glucose inbetween the cheeks. then i would go for D10, since i'm only an intermediate. ofcourse, i would have a paramendic on their way if D50, if i was unable to raise it myself. you really wont see a difference in blood sugar raise in 5 min or less... it takes a good 15 mins to see results... i know from experience...
 
I did not read every response given for this topic, so I may and probably repeat a few people.

You are asking us all to play armchair medic without being there and limited info.
with that said.

I agree with oral glucose and food 1st. many of have seen CAO patient with blood sugar levels (BGL) in the teens or even lower.

As you have said, you treat your Pt not your equipment. As someone else said BLS before ALS.

For question 2, should you have waited longer? tough to say. I think that comes down to your discretion. you were there and we were not. From what you have told us and the info given, I don't think it was bad...but as someone mentioned should always check bgl before D50...but D50 is not gonna ever makes thing all that worse even if their sugar was 500.

question 3: Thiamine was just removed from protocols this year. BUT I believe and many agree as well, as well disagree, but I believe Thiamine should always be given with D50 for more than the obvious reasons of malnutrition and alcohol. Thiamine does help to facilitate the glucose across the cell membranes. So I look at it as anything that will help their brains cells from dying.

question 4: in case with this that after eating and D50 and sugar still stayed low, transport (which you did). then the Monday morning medic questions, did you access for CVA, or anything else that help coz the low BGL, or diaphoresis? Did you put her on the monitor to take a look? any O2? again this all may have happened but info just omitted from story
 
I am a long time diabetic and having a very good track record with regulating my bgl personally (in excess of 20 years) I will say that (and I have the support of my personal endocrinologist and medical director) that if you can raise that persons bgl with food then that is the way to do it keeping in mind that you need to operate with in the confines of your services guidlines. Whenever you give glucose IV you are setting that diabetic up for days, weeks, even possibly months of getting their bgl regulated again. Feed them that is what they need and remember that digestion takes time. Until and unless your treatment plan would be to give them IO d50 if you could not get a line then oral is the way to go as long as they can protect their own airway as it sounds like your Pt could. Just my 2 cents as I have a personal interest in this subject.
 
Point well taken. I've seen various methods for raising the pt's BGL. I've seen the typical OJ, a peanut butter & jelly sandwich, soda, and a turkey and cheese cold cut sandwich, and of course the glocose tube. I personally prefer OJ/cranberry/apple juice until BGL WNL, then a Pb&J or two, for maintenance. What do you recommend?
 
46Young said:
Point well taken. I've seen various methods for raising the pt's BGL. I've seen the typical OJ, a peanut butter & jelly sandwich, soda, and a turkey and cheese cold cut sandwich, and of course the glocose tube. I personally prefer OJ/cranberry/apple juice until BGL WNL, then a Pb&J or two, for maintenance. What do you recommend?
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I agree. BLS before ALS. If the Pt can swallow safely, feed them. I had 1 diabetic who told me milk helps get her sugar up. So milk she got and it worked.

After I get their sugar back up with whatever I used, I tell them to eat a real meal, more than just a sandwich.
 
Milk, huh? Sounds like a great idea. speaking of which, have you ever heard of the gallon of milk in one hour challenge? The one tsp of cinammon challenge, or the six saltines in one minute challenge? We're so immature at my station. It's awesome.
 
46Young said:
Milk, huh? Sounds like a great idea. speaking of which, have you ever heard of the gallon of milk in one hour challenge? The one tsp of cinammon challenge, or the six saltines in one minute challenge? We're so immature at my station. It's awesome.
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I have heard of the 6 saltines in a minute...tried it...failed it...lmao

just so 46Young & I don't get attacked again for some of our comments...these challenges have NOTHING to do with patient care or would be tried on patients...
 
djmedic913 said:
just so 46Young & I don't get attacked again for some of our comments...these challenges have NOTHING to do with patient care or would be tried on patients...
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Really?? My next shift was going to be entertaining too. Damn
 
No, I'm just going off on one of my frequent tangents. I like to have fun at work, as long as I'm not hurting anyone. the cinammon challenge is on youtube.
 
the Cinnamon challenge!!!
its intense. everyone try it
 
On a serious note, things like cinammon, fish oil, and intense excercise have been shown to improve insulin resistance. A type II diabetic would be better off replacing all of their refined carbs with fruits, vegetables, nuts, quinoa and such. Stop making your pancreas work so hard. Coupled with exercise, they would eventually be able to wean themselves off of oral hypoglycemics. Orals just allow the pt to keep eating as they have, which is typically a big part of the problem in the first place.
 
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