Blood Glucose Test Case Study

Blood Glucose Test Case Study

Importance of Asking About Diabetes After Checking Level of Consciousness and Vitals

Asking whether the patient is diabetic is crucial because both hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar) can cause symptoms similar to intoxication, including slurred speech, confusion, and disorientation. Identifying whether the patient has diabetes can help healthcare providers quickly determine if the altered mental state is due to abnormal blood glucose levels and provide the appropriate treatment. Diabetic emergencies require immediate intervention to prevent further complications and ensure patient safety.

Hypoglycemia and Decreased Level of Consciousness

A hypoglycemic patient may present with a low level of consciousness because the brain uses glucose primarily as an energy source. Whenever the blood glucose levels become low, the brain ceases to receive the necessary energy to perform its functions. These effects may include confusion, slurred speech and or dizziness, seizures, and even loss of consciousness (Agrawal et al., 2022). If the above complications are left untreated, severe hypoglycemia may lead to coma or even death.

Hyperglycemia and Decreased Level of Consciousness

A hyperglycemic patient may manifest symptoms of altered consciousness because of diabetic ketoacidosis or hyperosmolar nonketotic coma. In DKA, due to the absence of insulin, fats are used as a source of energy and produce end products that are acidic, called the ketone bodies. It results in metabolic acidosis, which in turn affects the mental state. In HHS, severe dehydration and hyperosmolarity stemming from high blood sugar levels bring about mental changes, among them being reduced consciousness (Gosmanov et al., 2021).

Fruity Breath and Ketone Bodies

The patient has a fruity breath due to the presence of acetone, a kind of ketone body. When the body breaks down fats for energy instead of glucose—a process that happens when there is not enough insulin to allow glucose into cells—ketone bodies are generated. This state is called diabetic ketoacidosis (DKA) (Cantrell & Mohiuddin, 2020). In DKA, high levels of ketone bodies, including acetone, accumulate in the blood and are excreted in the breath, giving it a characteristic fruity odor. This condition is a medical emergency and requires prompt treatment to correct the metabolic imbalance and prevent serious complications.

References

Agrawal, S., Makuch, S., Dróżdż, M., Dudzik, T., Domański, I., Poręba, R., & Mazur, G. (2022). The Impact of Hypoglycemia on Patients with Diabetes Mellitus: A Cross-Sectional Analysis. Journal of Clinical Medicine, 11(3), 626. https://doi.org/10.3390/jcm11030626

Cantrell, C. B., & Mohiuddin, S. S. (2020). Biochemistry, Ketone Metabolism. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554523/

Gosmanov, A. R., Gosmanova, E. O., & Kitabchi, A. E. (2021, May 9). Hyperglycemic crises: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS). National Library of Medicine; Endotext. https://www.ncbi.nlm.nih.gov/books/NBK279052/

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Scenario
Blood Glucose Test

A person driving on Highway 11 towards New Orleans was reported scraping the side rails and swerving into the other lane. A brief police chase ensued. The police thought he was inebriated but began to question their first impression when they didn’t smell alcohol or drugs. They called for an ambulance and the individual was rushed to the ER. The patient had slurred speech. The patient wasn’t aware of where they were and couldn’t tell the medical staff the correct year either. There was a fruity smell noted on the patient’s breath.

Blood Glucose Test Case Study

Instructions
Answer the following questions and save your responses in a Microsoft Word document. Provide a scholarly resource in APA format to support your answers.

The very next question after checking the level of consciousness and vitals was whether he was diabetic, and why.
Why would a hypoglycemic patient possibly present with a decreased level of consciousness?
Why would a hyperglycemic patient possibly present with a decreased level of consciousness?
The patient’s breath has a fruity smell which is attributed to ketone bodies. Why are they present when the patient exhales and what is this state called?