Acute complications of diabetes - Hyperosmolar hyperglycemic nonketotic state | Khan Academy
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- čas přidán 24. 07. 2024
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My oldest son is in his early 20's and he has type 1 diabetes. But thank God for this piece of article czcams.com/users/postUgkxibD_L3sDyYENL5CwePCd9plRBqjzw2mw At first he thought he had the flu and was lying down on the bed for three days until his sister took him to the hospital. They took his blood and it was 600. What I do not understand is how he could have gotten it, since no one in the family has it. But he is winning the battle now. This is a good stuff.
scam dont listen
This was an amazingly simple but thorough explanation of HHNS. I found this video the easiest to follow along with by far.
Thanks for the video. The way you broke it down really helped me to understand this complication for my exam.
I wish i could like this a million times!!! Thanks.
Thank you so much!! Great explanation!!
Great explanation. Thank you for taking the time to do this clip.
Thank you so much, can't understand these things better and quick without you 👍👍👍
So helpful Mr. Khan! Thank you !❤️
Nice simplification! Websites articles I looked at were a bit hard to follow.
This is the best explanation.Thank you.
This is incredible, thank you so much
lifesaver!! such a clear explanation
This sounds to be Mr Areo Saffarzadeh's voice! In any case, highly commendable! Thanks a ton, Sir.
thank you very much, and if the sound would have been a bit higher, will be nice.
His voice 😍
Is there also a youtube video about what happens with the electrolyts during a HHNK state?
Thank you so much!
That was so great ! Thaaaanks a lot !!
very helpuful ! thank you very much :D
Thank you. Best explanation of the condition
Really important, thank you so much. Pls create more videos like this
excellent explanation!
Beautiful !
Great explanation!
Thank you very much, i wish i can hear you better.
Awesome explanation, but voice recording is a little low.
Your such a lifesaver
brilliant, thanks u
Great explained thanks
Explanation at its best, thanks a ton sir ! :D
Thank you
Thank you.
Excellent !
Beautiful lecture
Amazing ❤
How does intravenous insulin help in type 2 diabetes since they are not insulin deficient but desensitized to the hormone?
this is a question that I have always wondered about too. I'm just learning about diabetes pathophysiology in PA school now. Essentially what happens is that initially the pancreatic beta cells start secreting more insulin to counteract the cellular insulin resistance. The beta cells undergo hypertrophy and hyperplasia and eventually exhaust themselves after many many years of diabetes. Then they actually start to shrivel, and produce significantly less insulin. Less insulin + insulin resistance = dangerously elevated glucose. And that's when type 2 diabetics become "insulin dependent".. although that's debatable now too because new drugs like GLP-1 (Trulicity, Victoza, Ozempic) actually address the insulin resistance and hyperglycemia without causing weight gain. I'm definitely on board with not giving type 2 diabetics insulin unless it is absolutely necessary.
Why is HHNS much more severe than DKA?
Yes
Bravo!
Please... Turn up volume. It can't be overstated. From what I could hear, it was a good video. But I could only hear bits and pieces.
What are diagnostic procedures that confirm this and DKA
Super informative and clean graphics. Thanks for helping me review for my NCLEX exam.
Also: "starvation in the face of plenty"....story of our country!
What is the treatment of severe hypertension in HHS
QUESTION: If the person with Type 2 Diabetes has an deficiency in Insulin RECEPTORS, not in the production of Insulin... how would an INSULIN IV help this patient?
Because people with Type 2 DM usually produce insulin however they either don't produce enough OR their body does not use it effectively OR both. Therefore, exogenous insulin is helpful in cases of HHS where hyperglycemia needs to be reversed. You have to also take into account people with Type 2 DM are on oral agents that help with insulin resistance.
Because when you can't use it well more of it would be helpful to reach more cells or to prolong the effects
The basic idea behind it is if the DM 2 patient is given insulin, there is more available insulin in their system. The more insulin there is the more likely that insulin binds a receptor, and then exert its effects.
How can you explain.. So amazingly?????
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Need higher volume. Can't hear vid
I think I realize the voice in this video. Dr Paul Tran:)
If its mainly in type 2 shouldnt there be weight gain over loss?
shouldn't be the patient fluid resuscitated first before administration of insulin? what you suggest may cause vascular collapse, considering the patient is severely dehydrated
Thank you for the videos! Could you please explain something though, how is it that we treat HHNS with IV of insulin when only Type 2 can get this ... complication? ( Type 2 of DM can secrete insulin after all)
+Lyn M Some Type II diabetes patients only produce some but not enough insulin.
+Jasmine Li still, there is no answer from the tissues when insulin comes cuz its type 2, and i dont understand how this will help and threat HHNS
+Hazazzel World what? even in type 2, insulin will help unlock cells to accept the blood sugar & get it out of the blood stream. in fact with hhns the blood glucose level rises even higher than DKA so you'll definitely need iv insulin to get that sugar out of the bloodstream.
but explain me how will that insulin help the body when the tissue does not respond to insulin
Patients with type 2 diabetes are insulin resistant. So the insulin they are producing is not sufficient enough to signal the cells to reuptake the glucose in the bloodstream. Additional insulin must be give so that the cells will take in the glucose that is in their bloodstream.
How does this complication effects the electrolytes like potassium?
lolagurl007 insulin increases the activity of Na+/k+ pump.K+is extremely important in establishing RMP of muscles of type.In diabetes mellitus we observe hyperkalemia as the pump is not adequately activated.In such cases the membrane excitability increases leading to arrythmia & fibrillations,elevated T wave is noticed on ekg .Also on administration of insulin as in the treatment there is sudden entry of K+ into the cells leading to hypokalemia.Sym:muscle weakness,fatigue,cramps,arrythmias &if severe cardiac arrest ,T wave inversion is also noted.For better understanding watch osmosis vedios on this topic.Hope this helps.
Just a quick question, aren't solutes in the system decreases and not increase due to severe osmotic diuresis?
xyza corpuz in case you were still curious, you're still adding solutes to the blood stream, whole getting rid of others. i.e. in hhns you're building up glucose (a solute) in the blood, drawing fluid out of tissues. but with the polyurea you're getting rid of too many of other solutes (i.e. potassium).
What happens to the sodium level in the blood after HHNS has been treated?
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this is def the Sketchy Micro guy lol
The explanation is amazing. .... but the volume is seriously low....... can u please high the volume. ?
Volume is super low
U says that In treatment insuline may be given , But is it necessary to take , c - peptide test to evalute either indl have insuline i.e more than normal ranges And his cell receptors are not responding...And One should be treated With TCDs ....as U describe In urs One Of very nice clip ...diabetic pharmacology.
Please confirm thanks.
I don't know why I don't understand this because you are doing fantastic. but my Question is. for HHNS you stated glucose is osmotically active which means it goes where water goes. then proceeded to say the glucose is excreted through the kidneys because it is not being fully absorbed. if it is being excreted, how do they have high blood glucose levels? I may be over thinking this
I have the same thing your saying in my school notes I just don't fully understand how this is working O.O
polyuria alone cannot decrease the high blood glucose level because the body has limited amount of water. so when we start to treat we begin with slow rehydration of 0.9% Nacl IVI over 48 hours. only use insulin if blood glucose is not falling by 5mmol/L/Hour with rehydration or if ketonemia . correct me if im wrong .
But remedy Of insuline is temporary treatment.
What is the permanent treatment Of HHNS.
HHS is an acute complication of DM2 which may occur in patients with poor glycemic control or triggered by a stressor that increases metabolic demand (infection, infarction, inflammation, intoxication). Hyperglycaemia is the most important step in the pathogenesis of HHS. DM 2 is usually treated with a combination of medications that increase insulin secretion or insulin sensitivity or decrease glucose resorption from the kidneys. So adherence to their medications should control blood glucose and prevent HHS from developing.
Thanks
can you explain why some people develop DKA while others develop HHNS
DKA for T1DM while HHNS for T2DM ,, however T2DM can develope DKA ( very rare)
T1DM have absolute insulin deficiency when cells staving switches into FAT burning for energy whereby ketones are the byproducts,, in T2DM insulin deficit is relative , presence of insulin prevents FAT burning so no ketones are formed ..
Rewatch the clip u will get the concept
Thanx
Thanks you Dr Igudia on CZcams for all you do in my life and my family. I went for a test today after taking the medication i ordered from Dr Igudia and I tested type 2 Diabetes’s negative. Thanks doctor I will keep letting the world know about your good work sir.
T
My heart just keeps thanking you and thanking you Dr Igudia for all you have done for me, you gave me your words that you could heal any sickness or disease, thank you for permanently curing me of my diabetes you are amazing.
not loud enough
v
Testifying about Dr Igudia on CZcams is a great joy I have ever had in a while because this man transformed my life In all ramification. Thanks doctor for putting an end to my type 2 Diabetes and putting a smile on my face again
thanx but voice is too low
Thank you for never letting me down doc.
being recommended to doctor Igudia on CZcams has being a great blessing to my family his cure for Diabetes is a genuine one thanks for your good deed toward humanity
Why you whispering though?
Thel
I'm diabetic and I was in HHNS the other day. I didn't know what was happening to me, I was so confused and really nauseous, i kept peeing and had diarrhea when I tried to drink water (which was hard cuz I was dehydrated and nauseous) and i was so weak that I could barely speak. I just got on the floor in child's pose cuz everything was spinning and when I opened my eyes I was seeing double. Only had a small amount of keytones and I wasn't aware of HHNS, so I figured it was prostandaglins from a high blood sugar I had in my sleep which had since come back down. My whole body hurt and my abdominals and kidneys particularly hurt, my eyes were burning and my nose was running and tears kept coming out of my eyes. I just toughed it out then drank some diet coke when the nausea got less sever cuz water was too heavy. I took a urine test and came up with high levels of leukocytes and bilirubin, thats when I googled around and realized I was in HHNS. I really can't believe I made it though on my own. I hope it didn't hurt my kidneys too much.
Medicosis??? Is that u?
Voice like dying.