Diabetic and Endocrine Emergencies

Diabetic and Endocrine Emergencies

1. Where This Starts: Glucose Is the Brain's Only Fuel

Every cell in the body needs glucose for energy. Most tissue can switch to burning fat when glucose is scarce. The brain can't. It runs on glucose only, and it stores almost none of its own.

So when blood glucose drops, the brain is the first organ to fail, and it fails within minutes. That's why hypoglycemia is a true emergency and why it comes on fast.

Insulin is the hormone that lets glucose move out of the blood and into the cells. Without enough insulin, or without the body responding to it, glucose backs up in the blood instead of fueling the cells. That's diabetes. And it splits into two opposite emergencies:

• Too much insulin relative to the glucose available: hypoglycemia, blood sugar too low
• Too little insulin doing its job: hyperglycemia, blood sugar too high

You're going to see both. So the first skill in this lesson is telling them apart at the patient's side, because your treatment is completely different for each.