ABSTRACT
This chapter discusses: severe hypoglycaemia, diabetic ketoacidosis, and hyperosmolar hyperglycaemic state. Diabetes mellitus affects more than three million people in the UK, with many diabetics remaining undiagnosed until a crisis occurs. There are two different types of diabetes mellitus: type1 and type 2. Metabolic syndrome is a syndrome of inter-related metabolic problems, usually caused by obesity, resulting in hyperlipidaemia. Stress responses usually cause hyperglycaemia by increasing insulin resistance, but transient hyperglycaemia is usually mild, resolves with recovery, is not usually significant and is usually only treated if blood sugar persists above 10 mmol/litre. Severe hypoglycaemia may occur if diabetics: receive excessive insulin/hypoglycaemics, lack sugar and sugar sources, and develop increased resistance to insulin. UK guidelines for managing diabetic ketoacidosis emphasise the primacy of controlling ketoacidosis. Diabetes can cause widespread complications and problems throughout the body, so patients should be assessed and treated holistically.
