🩺 Comprehensive Diabetes Learning Module
Master diabetes care from fundamentals to advanced management - designed specifically for nursing professionals
🎓 Guided Tutorial: From Diabetes Basics to Expert Care
📖 Lesson 1: Understanding Diabetes Fundamentals
Welcome to your comprehensive diabetes education journey!
Diabetes mellitus is a group of metabolic disorders characterized by chronic hyperglycemia due to defects in insulin secretion, insulin action, or both.
🧪 Key Concept: Normal Glucose Control
- Fasting: 70-100 mg/dL - Normal range
- Postprandial: <140 mg/dL - 2 hours after eating
- HbA1c: <5.7% - 3-month average
🧠 Memory Aid: "DIABETES"
- Deficient insulin production or action
- Increased blood glucose levels
- Autoimmune (Type 1) or acquired (Type 2)
- Beta cells dysfunction
- Elevated HbA1c levels
- Thirst and frequent urination
- Energy loss and fatigue
- Systemic complications if uncontrolled
🏥 Why This Matters
Diabetes affects 11.6% of the US population (CDC 2024 data). As a nurse, you'll care for diabetic patients in every unit - from ICU to outpatient clinics. Understanding the fundamentals is crucial for providing safe, effective care.
🔄 Lesson 2: Normal vs Diabetic Glucose Metabolism
Let's understand how glucose metabolism works normally, then see what goes wrong in diabetes:
✅ Normal Metabolism
1. Eat food → Glucose enters bloodstream
2. Pancreas detects glucose → Releases insulin
3. Insulin acts like a "key" → Opens cells to glucose
4. Glucose enters cells → Blood sugar normalizes
❌ Diabetic Metabolism
Type 1: No insulin production (no keys)
Type 2: Insulin resistance (broken locks)
Result: Glucose stays in bloodstream
Consequence: High blood sugar + starving cells
🎯 The Classic Symptoms
Remember the "3 P's" + Weight Loss + Fatigue:
- Polyuria - Excessive urination (glucose spills into urine)
- Polydipsia - Excessive thirst (dehydration from urination)
- Polyphagia - Excessive hunger (cells are starving)
- Weight loss - Body breaks down muscle/fat for energy
- Fatigue - Cells can't get glucose for energy
📊 Lesson 3: Diagnosing Diabetes
Learn the official diagnostic criteria and how to interpret them:
| Test | Normal | Prediabetes | Diabetes |
|---|---|---|---|
| Fasting Glucose | <100 mg/dL | 100-125 mg/dL | ≥126 mg/dL |
| 2-Hour OGTT | <140 mg/dL | 140-199 mg/dL | ≥200 mg/dL |
| HbA1c | <5.7% | 5.7-6.4% | ≥6.5% |
| Random Glucose | N/A | N/A | ≥200 mg/dL + symptoms |
🎯 Practice Case
Patient Sarah, 45 years old:
• Fasting glucose: 132 mg/dL
• HbA1c: 7.2%
• Symptoms: Increased thirst, frequent urination
🎯 Lesson 4: Management Goals & Modern Medications
Learn the evidence-based targets and latest medication advances for diabetes care:
🎯 ABCs of Diabetes Care (Updated 2023)
- A1c <7% (individualized: <6.5% if low hypoglycemia risk, <8% if multiple comorbidities)
- Blood pressure <130/80 mmHg (2017 AHA/ACC guidelines)
- Cholesterol - LDL <100 mg/dL (<70 mg/dL for high CV risk patients)
🧠 Blood Glucose Targets (ADA 2023)
- Preprandial: 80-130 mg/dL
- Postprandial: <180 mg/dL (2 hours after meals)
- Bedtime: 100-140 mg/dL
- CGM Time-in-Range: >70% (70-180 mg/dL)
💊 Modern Medication Classes - Educational Overview
Common therapy patterns (Provider-determined): Metformin + lifestyle modifications
Additional options healthcare providers may consider:
- GLP-1 agonists - CV protection, weight loss (semaglutide, liraglutide)
- SGLT2 inhibitors - Heart failure and kidney protection
- DPP-4 inhibitors - Weight neutral, low hypoglycemia risk
- Dual GLP-1/GIP agonists - Newest class (tirzepatide)
- Insulin - When other medications insufficient
🎯 Nursing Knowledge Case
Patient John, 58, Type 2 diabetes + heart disease:
• On metformin, HbA1c still 8.2%
• BMI 32, wants to lose weight
• History of myocardial infarction
• Good insurance coverage
🌍 Lesson 5: Cultural Considerations & Special Populations
Understanding diabetes across diverse populations is crucial for providing culturally competent care:
📊 Diabetes Prevalence by Ethnicity
- American Indian/Alaska Native: 14.7% (highest risk)
- Hispanic/Latino: 12.5%
- Non-Hispanic Black: 11.7%
- Asian American: 9.2%
- Non-Hispanic White: 7.5%
🏥 Cultural Competency - "RESPECT"
- Rapport - Build trust and understanding
- Empathy - Acknowledge cultural perspectives
- Support - Include family and community
- Partnership - Collaborate on care plans
- Explanations - Use culturally appropriate language
- Cultural competence - Understand health beliefs
- Trust - Maintain confidentiality and respect
👶 Pediatric Diabetes Considerations
Key differences in children:
- Type 1 diabetes more common in children
- HbA1c goals: <7.5% for most children/adolescents
- Growth and development considerations
- School management plans required
- Family involvement essential
- Transition planning for adolescents
🎯 Cultural Scenario
Mrs. Garcia, 52, Hispanic, newly diagnosed with Type 2 diabetes:
• Says "susto" (fright) caused her diabetes
• Prefers traditional remedies
• Large extended family wants to help
• Limited English proficiency
💝 Lesson 6: Psychosocial Support & Patient Emotions
Diabetes diagnosis and management significantly impact emotional well-being:
😔 Common Emotional Responses
- Denial: "This can't be happening to me"
- Anger: "Why me? This isn't fair!"
- Bargaining: "If I lose weight, maybe it will go away"
- Depression: "My life is over"
- Acceptance: "I can learn to manage this"
🤝 Supporting Patients - "SUPPORT"
- Safety - Assess for depression/suicide risk
- Understanding - Validate their feelings
- Partnership - Involve them in care decisions
- Positive focus - Highlight what they can control
- Outreach - Connect with support groups
- Resources - Provide educational materials
- Team approach - Coordinate with mental health
⚠️ Diabetes Distress vs Depression
Diabetes Distress: Emotional burden of living with diabetes (20-40% prevalence)
Clinical Depression: Major depressive disorder (8-15% prevalence in diabetes)
Both require: Screening, support, and potential referral to mental health professionals
🎯 Emotional Support Scenario
Maria, 28, Type 1 diabetes, 6 months post-diagnosis:
• "I hate checking my blood sugar - it ruins everything"
• Avoids social events with food
• HbA1c rising from 7.2% to 8.1%
• Reports feeling "different" and "broken"
🚨 Lesson 7: Recognizing Acute Complications
Learn to identify and respond to life-threatening diabetic emergencies:
🔥 Diabetic Ketoacidosis (DKA)
Who: Mainly Type 1, some Type 2
Cause: Absolute insulin deficiency
Symptoms: Kussmaul breathing, fruity breath, altered mental status
Labs: Glucose >250 mg/dL, ketones >3.0 mM, pH <7.3, anion gap >10
💧 Hyperosmolar Hyperglycemic State (HHS)
Who: Mainly Type 2, elderly
Cause: Severe dehydration + hyperglycemia
Symptoms: Severe dehydration, altered consciousness
Labs: Glucose >600 mg/dL, osmolality >320 mOsm/kg
🧠 DKA vs HHS - "KETONES"
- Ketones present = DKA; Absent = HHS
- Extreme glucose: DKA 250-600, HHS >600
- Type: DKA = Type 1, HHS = Type 2
- Onset: DKA hours-days, HHS days-weeks
- Neurologic: DKA mild-moderate, HHS severe
- Emergency: Both need immediate treatment
- Solution: IV fluids + insulin for both
⚠️ Hypoglycemia Recognition
Mild (<70 mg/dL): Shakiness, sweating, hunger
Moderate (<54 mg/dL): Confusion, irritability, weakness
Severe (<40 mg/dL): Unconsciousness, seizures, coma
Treatment: 15g fast-acting carbs, recheck in 15 minutes (Rule of 15)
🎯 Emergency Recognition
Patient arrives in ED:
• Altered mental status, dehydrated
• Kussmaul respirations, fruity breath
• Blood glucose: 385 mg/dL
• Urine ketones: Large
📚 Lesson 8: Mastering Patient Education
Develop skills to effectively educate and empower diabetes patients:
🎯 Core Education Topics
- Disease Knowledge: What diabetes is and isn't
- Monitoring: Blood glucose testing, CGM use
- Medications: Purpose, timing, side effects
- Nutrition: Carb counting, portion control
- Exercise: Safe activity guidelines
- Sick Day Management: When to call provider
- Complications: Prevention and early detection
🧠 Teaching Strategies - "TEACH"
- Tune in to patient's learning style
- Explain concepts in simple terms
- Ask for return demonstration
- Clarify misconceptions immediately
- Highlight most important points
🎯 Teaching Challenge
Mr. Thompson, 72, newly diagnosed Type 2:
• "I don't want to take insulin - that means I'm dying"
• Low health literacy
• Lives alone, fixed income
• Afraid of needles
🏆 Final Knowledge Assessment
Congratulations! You've completed the comprehensive guided tutorial. Now let's test your knowledge with enhanced scenarios:
Question 1 of 8
What is the normal fasting blood glucose range?
Question 2 of 8
Which mnemonic helps remember diabetes symptoms?
Question 3 of 8
What HbA1c level indicates diabetes?
Question 4 of 8
What do the ABCs of diabetes care stand for?
Question 5 of 8
What are the classic "3 P's" of diabetes?
Question 6 of 8
Clinical Scenario: A 12-year-old presents with DKA. Which ethnic group has the highest diabetes prevalence?
Question 7 of 8
Cultural Competency: A Hispanic patient attributes diabetes to "susto" (fright). Your best response is:
Question 8 of 8
Psychosocial Care: A newly diagnosed patient says "My life is over." This represents which stage of grief?
📊 Types of Diabetes & Pathophysiology
🔍 Understanding Diabetes Classification
Diabetes mellitus encompasses several distinct conditions with different causes, onset patterns, and management approaches. Understanding these differences is crucial for providing appropriate nursing care.
🔴 Type 1 Diabetes (T1DM)
~5-10% of cases🧬 Pathophysiology
Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency
📋 Key Features
- Usually diagnosed in children/young adults
- Sudden onset of symptoms (days to weeks)
- Requires lifelong insulin therapy
- High risk for DKA if insulin missed
- Often normal or low BMI at diagnosis
⚠️ Risk Factors
Genetic predisposition, environmental triggers, viral infections
🔵 Type 2 Diabetes (T2DM)
~90-95% of cases🧬 Pathophysiology
Insulin resistance with progressive beta cell dysfunction over time
📋 Key Features
- Usually diagnosed in adults >40 years
- Gradual onset (months to years)
- Often asymptomatic initially
- May be managed with lifestyle + medications
- Strong association with obesity
⚠️ Risk Factors
Obesity, family history, sedentary lifestyle, age, ethnicity
🟡 Gestational Diabetes (GDM)
~6-9% of pregnancies🧬 Pathophysiology
Pregnancy hormones cause insulin resistance, first recognized during pregnancy
📋 Key Features
- Develops in 2nd or 3rd trimester
- Usually resolves after delivery
- Increases risk for future T2DM
- Requires close monitoring during pregnancy
- Risk to both mother and baby
⚠️ Risk Factors
Previous GDM, family history, obesity, age >25, certain ethnicities
📊 Quick Comparison Chart
| Factor | Type 1 | Type 2 | Gestational |
|---|---|---|---|
| Age of Onset | Usually <30 years | Usually >40 years | During pregnancy |
| Onset Speed | Rapid (days-weeks) | Gradual (months-years) | 2nd-3rd trimester |
| Body Weight | Normal/underweight | Often overweight | Variable |
| Insulin Need | Always required | May be needed | Sometimes needed |
| DKA Risk | High | Low | Low |
🎯 Classic Presentation
🧠 Remember: "3 P's + 2"
Excessive urination due to glucose spillage
Excessive thirst from dehydration
Excessive hunger due to cellular starvation
Unexplained weight loss (especially T1DM)
Lack of energy from glucose utilization problems
🔬 Diagnostic Criteria
| Test | Normal | Prediabetes | Diabetes |
|---|---|---|---|
| Fasting Glucose | <100 mg/dL | 100-125 mg/dL | ≥126 mg/dL |
| 2-Hour OGTT | <140 mg/dL | 140-199 mg/dL | ≥200 mg/dL |
| HbA1c | <5.7% | 5.7-6.4% | ≥6.5% |
| Random Glucose | N/A | N/A | ≥200 mg/dL + symptoms |
Note: Two abnormal test results on different days are required for diagnosis (except for random glucose with symptoms)
💊 Diabetes Management Strategies
🎯 Nursing Role in Diabetes Management
Educational Focus: Nurses play a crucial role in diabetes care through patient education, monitoring, and support - not prescribing. This section covers treatment patterns you'll observe in practice to help you understand your role in the healthcare team.
🏃♂️ Lifestyle Modifications
Mnemonic: "LIFESTYLE"
- Lose excess weight
- Increase physical activity
- Follow meal planning
- Education and self-management
- Stress management
- Tobacco cessation
- Yearly health screenings
- Limit alcohol consumption
- Engage support systems
💊 Pharmacological Management
🧬 Insulin Types Overview
For Type 1 diabetes (and advanced Type 2), insulin therapy is essential. Understanding insulin types helps optimize glucose control.
💊 Type 2 Medications
🍽️ Nutritional Management
15g carbs = 1 serving. Track total carbs per meal for better glucose control
½ plate vegetables, ¼ lean protein, ¼ complex carbs, plus healthy fat
Choose low GI foods that cause slower blood sugar rises
Consistent meal times help maintain stable blood glucose levels
🎯 Common Treatment Patterns in Type 2 Diabetes
Typical Step-wise Approach (Provider-determined):
- Initial: Lifestyle modifications + Metformin (commonly used)
- Additional: Add second agent based on patient factors
- Intensify: Triple therapy or insulin initiation
- Complex: Intensify insulin or complex combinations
Note: All medication decisions must be made by qualified healthcare providers based on individual patient assessment.
💡 Patient Education Tips
- Use visual aids like food models or the plate method
- Provide written materials in patient's language
- Demonstrate blood glucose monitoring techniques
- Role-play scenarios for managing social situations
- Connect patients with diabetes educators and support groups
- Emphasize gradual lifestyle changes for sustainability
- Address barriers to medication adherence
🎯 Nursing Assessment & Education
Case Study: A 55-year-old patient with newly diagnosed Type 2 diabetes, HbA1c 8.2%, BMI 32. What is your priority nursing intervention?
⚠️ Signs & Symptoms Recognition
🔍 Clinical Assessment Framework
Early recognition of diabetic symptoms can prevent serious complications. Use systematic assessment to identify both acute and chronic manifestations.
🚨 Acute Symptoms (Hyperglycemia)
Mnemonic: "THIRSTY"
- Thirst (polydipsia)
- Hunger (polyphagia)
- Increased urination (polyuria)
- Reduced energy/fatigue
- Skin problems (slow healing)
- Tingling (neuropathy)
- Yearning for relief (irritability)
⏰ Chronic Complications
Mnemonic: "DIABETIC"
- Dermopathy (skin changes)
- Infections (frequent)
- Arterial disease
- Blindness risk (retinopathy)
- End-stage renal disease
- Tingling/numbness (neuropathy)
- Impaired wound healing
- Cardiovascular disease
📋 Nursing Assessment Checklist
Check BP (hypertension common), heart rate, respiratory rate, temperature
Check for wounds, infections, acanthosis nigricans, skin tags
Test sensation in feet, check reflexes, assess for neuropathy
Inspect for ulcers, calluses, deformities, pulse checks
🎯 Symptom Recognition Quiz
Scenario: A 45-year-old patient reports increased thirst, frequent urination, and blurred vision for 2 weeks. What's your priority assessment?
• Hyperglycemia (>250 mg/dL)
• Ketosis (serum ketones ≥3 mmol/L or urine ketones 2+)
• Acidosis (pH <7.3 and/or HCO3 <18 mEq/L)
• Anion gap >10-12 mEq/L
Signs: Fruity breath, Kussmaul respirations, altered mental status, dehydration
• Severe hyperglycemia (>600 mg/dL)
• Hyperosmolality (>320 mOsm/kg)
• Severe dehydration
• No significant ketosis
Signs: Altered consciousness, severe dehydration
• Sweating, shakiness, hunger
• Confusion, irritability
• Rapid heartbeat
• If severe: seizures, coma
Treatment: 15g fast-acting carbs (15-15 rule)
🔄 Chronic Complications
Mnemonic: "CHRONIC"
- Cardiovascular disease (leading cause of death)
- Hypertension and dyslipidemia
- Retinopathy (leading cause of blindness)
- Osteomyelitis and infections
- Nephropathy (leading cause of ESRD)
- Impaired wound healing
- Cerebrovascular disease (stroke risk)
🎯 Prevention Strategies
ABCs of Diabetes Care:
- A1c <7% (individualized goals)
- Blood pressure <130/80 mmHg (2017 AHA/ACC guidelines)
- Cholesterol - LDL <100 mg/dL (<70 mg/dL for high CV risk)
💉 Advanced Insulin Therapy & Calculations
🎯 Advanced Insulin Management
This section covers detailed insulin types, dosing calculations, administration techniques, and troubleshooting - building on the insulin overview in the Management tab.
🧬 Understanding Insulin
Insulin is essential for glucose uptake by cells. In diabetes, either insufficient insulin is produced or cells become resistant to insulin action.
| Insulin Type | Onset | Peak | Duration | Examples |
|---|---|---|---|---|
| Rapid-Acting | 5-15 min | 1-2 hours | 3-4 hours | Lispro, Aspart, Glulisine |
| Short-Acting | 30-60 min | 2-4 hours | 5-8 hours | Regular insulin |
| Intermediate | 1-3 hours | 4-12 hours | 12-18 hours | NPH insulin |
| Long-Acting | 1-4 hours | Minimal peak | 20-24 hours | Glargine, Detemir |
| Ultra-Long | 1-6 hours | No peak | 42+ hours | Degludec |
🧠 Insulin Injection Sites - "SALAT"
- Stomach/Abdomen (fastest absorption)
- Arm (moderate absorption)
- Leg/Thigh (slower absorption)
- Alternate sites to prevent lipodystrophy
- Two finger widths from previous injection
📋 Injection Technique Checklist
Wash hands thoroughly or use alcohol sanitizer
Choose clean, non-irritated site. Rotate locations
90° angle for normal weight, 45° for thin patients
Hold 10 seconds, don't massage, dispose safely
🎯 Insulin to Carb Ratio Reference
📚 Understanding Insulin-to-Carb Ratios
Insulin-to-carb ratios are individualized prescriptions determined by healthcare providers based on patient factors like weight, activity level, and insulin sensitivity.
Common Ratio Examples (Provider-Determined)
| Ratio | Meaning | Example Context |
|---|---|---|
| 1:10 | 1 unit per 10g carbs | Higher insulin sensitivity |
| 1:15 | 1 unit per 15g carbs | Common starting point |
| 1:20 | 1 unit per 20g carbs | Lower insulin needs |
🏥 Nursing Role
- Teach patients to follow their prescribed ratios
- Monitor for signs of hypo/hyperglycemia
- Document patient understanding and compliance
- Report concerning glucose patterns to providers
- Emphasize importance of medical supervision
⚠️ Insulin Storage & Safety
- Storage: Unopened vials in refrigerator, opened vials at room temp for 28 days
- Travel: Keep in carry-on luggage, bring extra supplies
- Mixing: Clear before cloudy insulin when mixing
- Expiration: Check dates regularly, discard expired insulin
- Appearance: Clear insulins should be clear, cloudy insulins should mix evenly
💡 Patient Teaching Points
- Demonstrate proper injection technique repeatedly
- Practice with saline injections first
- Use injection pads for practice
- Emphasize site rotation importance
- Teach recognition of injection site problems
- Review timing of insulin with meals
📈 Blood Glucose Monitoring & Labs
🩸 Self-Monitoring Blood Glucose (SMBG)
When to Test - "MEALS"
- Morning (fasting)
- Eating (before meals)
- After meals (2 hours post-meal)
- Late evening (bedtime)
- Sick days or stress
| Time | Target Range | Clinical Significance |
|---|---|---|
| Fasting | 80-130 mg/dL | Reflects basal insulin needs |
| Pre-meal | 80-130 mg/dL | Guides mealtime insulin |
| 2-hr post-meal | <180 mg/dL | Assesses meal insulin adequacy |
| Bedtime | 100-140 mg/dL | Prevents nocturnal hypoglycemia |
📊 HbA1c Calculator
HbA1c Goals by Population:
- Most adults: <7%
- Elderly/comorbidities: <8%
- Pregnancy: <6-6.5%
- Children/adolescents: <7.5%
🔬 Laboratory Monitoring Schedule
Every 3 months if not at goal, every 6 months if stable at goal
Annually, or more frequently if abnormal or on lipid therapy
Annual creatinine, eGFR, and microalbumin screening
Annual dilated eye exam by ophthalmologist
🎯 Continuous Glucose Monitoring (CGM)
Benefits of CGM:
- Real-time glucose readings every 1-5 minutes
- Trending arrows showing glucose direction
- Customizable alarms for high/low glucose
- Reduces need for frequent fingersticks
- Provides data on time-in-range metrics
- Time-in-Range Goal: >70% (70-180 mg/dL target range)
- Standard of care for Type 1 diabetes and insulin-requiring Type 2
🎯 Monitoring Knowledge Check
Question: A patient's HbA1c is 8.5%. What does this indicate?
🎮 Diabetes Medication Match Game
🎯 Game Instructions
Drag each medication from the left side into the correct drug class category on the right. This interactive game helps you memorize the different classes of diabetes medications and their examples.
🏥 Drag Medications to Categories
⚡ Rapid-Acting Insulin
🕰️ Long-Acting Insulin
⏱️ Intermediate-Acting Insulin
⏰ Short-Acting Insulin
🥇 Biguanides
🔥 Sulfonylureas
🧬 DPP-4 Inhibitors
💪 GLP-1 Agonists
🚰 SGLT-2 Inhibitors
📚 Quick Reference Summary
💉 Insulin Categories
Rapid: Lispro, Aspart, Glulisine (5-15 min onset)
Short: Regular insulin (30-60 min onset)
Long: Glargine, Detemir, Degludec (20-24+ hr duration)
Intermediate: NPH (4-12 hr peak)
💊 Oral Medications
Remember: "-gliptin" = DPP-4, "-gliflozin" = SGLT-2
Metformin: Commonly used in T2DM management
⚠️ Key Nursing Considerations
Hypoglycemia risk: Insulin, Sulfonylureas
GI effects: Metformin, GLP-1 agonists
🆘 Emergency Management
⚠️ Important: Educational Content Only
The following information is for educational purposes only. Always follow your facility's specific protocols, physician orders, and evidence-based guidelines. Emergency management must be individualized based on patient condition and institutional policies.
🚨 PRIORITY: Hypoglycemia Management
Blood glucose <70 mg/dL or symptoms of hypoglycemia
⚡ Hypoglycemia Treatment - "15-15 Rule"
Glucose tablets, juice, honey, or hard candy
Allow time for glucose absorption and blood sugar rise
If still <70 mg/dL, repeat treatment
Provide protein + complex carb if meal is not soon
🧠 Fast-Acting Carb Sources (15g each)
- 3-4 glucose tablets
- 4 oz fruit juice or regular soda
- 1 tbsp honey or sugar
- 6-8 hard candies
- 2 tbsp raisins
🩺 DKA Management Protocol
Assessment Priorities:
- ABCs (Airway, Breathing, Circulation)
- Mental status assessment
- Vital signs and fluid status
- Blood glucose, ketones, ABG
Treatment - "FLUID-IK"
- Fluid replacement (NS initially)
- Low-dose insulin infusion
- Understand underlying cause
- Inpatient monitoring required
- Discontinue when ketones clear
- Interventions for K+ replacement
- Keep close neurological monitoring
💧 HHS Management Protocol
Key Differences from DKA:
- Higher mortality rate
- More gradual onset
- Severe dehydration priority
- Lower insulin requirements
Aggressive IV fluid replacement - priority intervention
Monitor and replace K+, Mg2+, PO4-
Lower insulin doses than DKA
Frequent assessment for cerebral edema
🚨 When to Call Provider IMMEDIATELY
- Blood glucose <50 mg/dL or patient unconscious
- Persistent vomiting preventing oral intake
- Blood glucose >400 mg/dL with ketones
- Signs of dehydration or altered mental status
- Chest pain or difficulty breathing
- Temperature >101°F with high glucose
🎯 Emergency Scenarios Practice
📚 Sources and References ▼
Click to view 6 sources cited
⚠️ Important Medical and Legal Disclaimer
FOR EDUCATIONAL PURPOSES ONLY: This learning module is designed exclusively for nursing education and should never replace clinical judgment, physician orders, institutional protocols, or current evidence-based practice guidelines. All diabetes management decisions must be made by qualified healthcare providers based on individual patient assessment.
NO MEDICAL ADVICE: This content does not constitute medical advice, diagnosis, or treatment recommendations. Always consult with healthcare providers for patient-specific care decisions. Medication dosing, treatment protocols, and emergency procedures may vary by institution and patient population.
INSTITUTIONAL COMPLIANCE: Always follow your facility's policies, procedures, and clinical guidelines. When in doubt, consult with your supervisor, physician, or clinical pharmacist.