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**HAVE to EAT while drinking alcohol**oDM T1: ExerciseActivity increase insulin absorptionMay need snacks for PE, Recess, Sports oHypo/HyperglycemiaHYPOPale, weak, dizzy, sweating, shaking, irritable, HA, Stomach ache, change in personality, “feel low”, seizureHYPERGradual onset of symptomsMight see the symptoms of DKA come on oNursing Intervention: HYPOglycemia
Blood sugar < 70and symptoms:Immediateintake of simple sugarsoJuice o2 glucose tablets15 minutes later, recheckRemains <70 – repeat simple sugars>80 – more substantial (fat, protein) snack (or meal within 30 minutes)Unable to eat or drink Honey or icing under tongue (only if still conscious)Glucagon injection10-15 minutes recheck glucoseMore substantial snack or mealConsider transport to ERoDM T1: EducationPatient and family will need to meet with a diabetes educator, nutritionist, if availableInsulin AdministrationNutritionIllnessExerciseBlood glucose monitoringSigns & Symptoms/TreatmentHypoglycemiaHyperglycemiaCoping and SupportoDM ComplicationsDKA, coma, deathMicrovascular Damage from excess glucosecan lead to:Heart and blood vessel diseaseNeuropathy Kidney damageRetinopathyFoot injuriesPregnancy complicationsoType 2 DMPathophysiology and treatment for children with Type 2 is the same as for adultsFocus heavily on decreasing weight and increasing physical activityTry to manage without medicationsCan use oral hypoglycemic agents (like Metformin) and insulinWill often see acanthosis nigricansDisorders of Pituitary FunctionoHYPOpituitarism – talking about effects of the ANTERIOR Pituitary Diminished or deficient secretion of pituitary hormonesGrowth HormoneoStimulates linear growthoBuilds bone mineral densityoStimulates growth of all body tissuesoStimulates synthesis of proteins in Liver (including insulin-like growth factor) Thyroid-Stimulating HormoneGonadotropinsAdrenocorticotropic HormoneMelanocyte-Stimulating HormoneProlactinOxytocinAntidiuretic Hormoneo**BLUE = POSTERIOR Pituitary
CausesIdiopathic (most cases are idiopathic)CNS infectionInfarction of pituitary glandCNS diseaseTumors of pituitary or hypothalamusBrain traumaChemotherapyS&SClassic Symptoms:oGrowth RetardationoShort StatureoDelayed bone maturation and muscle massX-rays of the hands can tell us where they are compared to chronological age S&S in INFANTNormal birth weightBy 1 year below 3rdpercentile for heightMay be hypoglycemic (increased insulin sensitivity)HyponatremicSeizures – low sodium/glucoseJaundice - prolongedUndescended testes with micro penisS&S in the CHILDHeight below 3rdpercentileOverweight - **Still gain weight, just do not grow taller**Youthful facial features – cherubic look Higher pitched voicesDelayed dentitionDecreased muscle massDelayed skeletal and sexual maturationHypoglycemia due to increased insulin sensitivityDiagnosis