Fatima was brought confused

Causes of confusion
1. Critical
  1. Shock and hypoxia
    1. Hypoglycemia
      1. Head infections
        Hypertensive encephalopathy
2. Emergent
  1. Metabolic diseases
    1. Hepatic encephalopathy/failure
      1. Sepsis
        Drugs and poisons
Insulin
1. Insulin activation
2. Insulin secretion mechanism
Diabetes
1. Types
2. Physical examination
  1. Skin
    1. Eyes
      1. Feet assessment
      2. Weight
    2. Blood pressure
3. Investigations
  1. Blood glucose : fasting glucose >126, Postprandial >200
    1. HbA1C (glaciated hemoglobin)
      1. Ketone testing
        Urine for glucosurea and ketonurea
  2. Complications
    1. Small blood vessels
      1. Hyaline arteriosclerosis
      2. Efferent blood vessels
        Nephrotic syndrome
      3. Afferent blood vessels
        glomerulosclerosis
        Chronic renal failure
    2. Osmotic damage PK-C pathway
      1. Schwann cells
        Loss of myelin in PNS
        Neuropathies
      2. lens
        Cataract
      3. Pericytes
        aneurysms
        Hemorrhage
        Blindness
    3. Management
      1. Biguanides
        GLP-1 receptor agonists
        DPP-4 inhibitors
        SGLT-2 inhibitors
        Sulfonylureas
        Insulin
        Alpha glucosidase inhibitors
Hyperosmolar hyperglycemic state
1. A serious condition caused by extremely high blood sugar levels.
2. Causes
  1. Illness or infection.
    1. Not following a diabetes treatment plan
      1. Certain medications
  2. Labs
    1. Hyperglycemia.
      1. Increase serum osmolality
        No acidosis

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Fatima was brought confused

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	Created by Fatima Alkhateeb about 6 years ago