Hopp til innhold
NHI.no
Annonse

Diabetes, akuttsituasjoner (førstehjelp): For lavt blodsukker (hypoglykemi)

Innhold i artikkelen

Typiske symptomer og tegn

  • Opptrer først og fremst hos pasienter som bruker insulin
  • Svetter - kald, klam og blek hud
  • Kraftig puls og hjertebank
  • Sultfølelse, svakhet, vil besvime
  • Forvirring og reagerer dårlig på tiltale
  • Overflatisk pust
Annonse

Førstehjelp til våken pasient når du vet at blodsukkeret er lavt

  • Gi sukkerrik drikke eller mat
    • Be vedkommende sette seg ned
    • Gi søt drikke eller noe søtt å spise
  • Be vedkommende hvile
    • Etter som vedkommende begynner å føle seg bedre, kan du gi mer mat eller drikke
    • Vedkommende må ta det med ro
    • Kanskje bør pasienten i ettertid konferere med legen sin om behandlingen

Dette dokumentet er basert på det profesjonelle dokumentet Diabetes type 1 . Referanselisten for dette dokumentet vises nedenfor

  1. Atkinson MA, Eisenbarth GS, Michels AW. Type 1 diabetes. Lancet. 2014 Jan 4; 383(9911): 69–82. www.ncbi.nlm.nih.gov
  2. Helsedirektoratet. Nasjonal faglig retningslinje for diabetes. Sist oppdatert 15.04.2020. helsedirektoratet.no
  3. American Diabetes Association. Clinical practice recommendations. Diabetes Care 2005; 28(suppl 1): S1-S79.
  4. Lambert AP, Gillespie KM, Thomson G, et al. Absolute risk of childhood-onset type 1 diabetes defined by human leukocyte antigen class II genotype: a population-based study in the United Kingdom. J Clin Endocrinol Metab 2004; 89: 4037-43. PubMed
  5. Atkinson MA, Roep BO, Posgai A, Wheeler DCS, Peakman M. The challenge of modulating β-cell autoimmunity in type 1 diabetes. Lancet Diabetes Endocrinol. 2019;7(1):52-64. PMID: 30528099. PubMed
  6. Krogvold L, Edwin B, Buanes T, et al. Detection of a low-grade enteroviral infection in the islets of langerhans of living patients newly diagnosed with type 1 diabetes. Diabetes 2015; 64: 1682-7. pmid:25422108 PubMed
  7. Kakleas K, Karayianni C, Critselis E, et al. The prevalence and risk factors for coeliac disease among children and adolescents with type 1 diabetes mellitus. Diabetes Res Clin Pract 2010;90:202-208. PubMed
  8. Davis AK, DuBose SN, Haller MJ, et al. Prevalence of detectable C-peptide according to age at diagnosis and duration of type 1 diabetes. Diabetes Care December 17, 2014. Published online before print December 17, 2014, . doi:10.2337/dc14-1952 DOI
  9. Wang L, Lovejoy NF, Faustman DL. Persistence of prolonged C-peptide production in type 1 diabetes as measured with an ultrasensitive C-peptide assay. Diabetes Care 2012; 35: 465-70. pmid:22355018 PubMed
  10. Atkinson MA, Eisenbarth GS. Type 1A diabetes: new perspectives on disease pathogenesis and treatment. Lancet 2001;358: 221-9. PubMed
  11. Harjutsalo V, Podar T, Tuomilehto J. Cumulative incidence of type 1 diabetes in 10,168 siblings of Finnish young-onset type 1 diabetic patients. Diabetes 2005; 54: 563-69. PubMed
  12. Norris JM, Beaty B, Klingensmith G, Yu L, Hoffman M, Chase HP, et al. Lack of association between early exposure to cow's milk protein and -cell autoimmunity: diabetes autoimmunity study in the young (DAISY). JAMA 1996;276: 609-14. Journal of the American Medical Association
  13. Hober D, Sauter P. Pathogenesis of type 1 diabetes mellitus: interplay between enterovirus and host. Nat Rev Endocrinol 2010;6:279-289 PubMed
  14. Norris JM, Barriga K, Klingensmith G, Hoffman M, Eisenbarth GS, Erlich HA, et al. Timing of initial cereal exposure in infancy and risk of islet autoimmunity. JAMA 2003;290: 1713-20. Journal of the American Medical Association
  15. Ziegler AG, Schmid S, Huber D, Hummel M, Bonifacio E. Early infant feeding and risk of developing type 1A diabetes-associated autoantibodies. JAMA 2003;290: 1721-8. Journal of the American Medical Association
  16. Lombardi A, Tsomos E, Hammerstad SS, Tomer Y. Interferon alpha: The key trigger of type 1 diabetes. J Autoimmun. 2018;94:7-15. PMID: 30115527. PubMed
  17. Fousteri G, Dave Jhatakia A. Viral Infections and Autoimmune Disease: Roles of LCMV in Delineating Mechanisms of Immune Tolerance. Viruses. 2019;11(10):885. Published 2019 Sep 21. PMID: 31546586. PubMed
  18. Usher-Smith JA, Thompson MJ, Sharp SJ, Walter FM. Factors associated with the presence of diabetic ketoacidosis at diagnosis of diabetes in children and young adults; a systematic review. BMJ 2011; 343: d4092. BMJ (DOI)
  19. Crawford F, Cezard G, Chappell FM, et al. A systematic review and individual patient data meta-analysis of prognostic factors for foot ulceration in people with diabetes: the international research collaboration for the prediction of diabetic foot ulcerations (PODUS). Health Technol Assess. 2015 Jul;19(57):1-210. PubMed
  20. Hals IK, Fiskvik Fleiner H, Reimers N, et al. Investigating optimal β-cell-preserving treatment in latent autoimmune diabetes in adults: Results from a 21-month randomized trial.. Diabetes Obes Metab 2019; 21: 2219-27. pmid:31148332 PubMed
  21. Lind M et al. HbA1c level as a risk factor for retinopathy and nephropathy in children and adults with type 1 diabetes: Swedish population based cohort study. BMJ 2019 Aug 28; 366:l4894. pmid: 31462492 PubMed
  22. Birkeland KI. Insulinbehandling ved type 1-diabetes hos voksne. Tidsskr Nor Legeforen 2006; 126: 776-8. PubMed
  23. Sustained effect of intensive treatment of type 1 diabetes mellitus on development and progression of diabetic nephropathy: the Epidemiology of Diabetes Interventions and Complications (EDIC) study. JAMA 2003; 290: 2159-67. Journal of the American Medical Association
  24. Nathan DM, Cleary PA, Backlund JY, et al, for the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group. Intensive diabetes treatment and cardiovascular disease in patients with Type 1 diabetes. N Engl J Med 2005; 353: 2643-53. New England Journal of Medicine
  25. Musso G, Sircana A, Saba F, et al. Assessing the risk of ketoacidosis due to sodium-glucose cotransporter (SGLT)-2 inhibitors in patients with type 1 diabetes: A meta-analysis and meta-regression. PLoS Med. 2020 Dec 29;17(12):e1003461. PMID: 33373368 PubMed
  26. Avgerinos I, Manolopoulos A, Michailidis T, et al. Comparative efficacy and safety of glucose-lowering drugs as adjunctive therapy for adults with type 1 diabetes: A systematic review and network meta-analysis. Diabetes Obes Metab. 2020. PMID: 33300282 PubMed
  27. Thalange N, Bereket A, Larsen J, et al. Insulin analogues in children with Type 1 diabetes: a 52-week randomized clinical trial. Diabet Med 2013 Feb; 30(2): 216-25. PubMed
  28. Lane W, Bailey TS, Gerety G, et al. Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Patients With Type 1 Diabetes The SWITCH 1 Randomized Clinical Trial. JAMA 2017; 318: 33-44. doi:10.1001/jama.2017.7115 DOI
  29. Davies MJ, Gross JL, Ono Y, et al. Efficacy and safety of insulin degludec given as part of basal-bolus treatment with mealtime insulin aspart in type 1 diabetes: a 26-week randomized, open-label, treat-to-target non-inferiority trial. Diabetes Obes Metab. 2014 Apr 7.
  30. Nørgaard K, Sohlberg A, Goodall G. Omkostningseffektivitet ved behandling af type 1-diabetes med insulinpumpe. Ugeskr Læger 2010; 172: 2020. Ugeskrift for Læger
  31. Bergenstal RM, Tamborlane WV, Ahmann A, et al. Effectiveness of Sensor-augmented insulin-pump therapy in type 1 diabetes. N Engl J Med, June 29, 2010.
  32. Russell SJ, El-Khatib FH, Sinha M, et al. Outpatient Glycemic Control with a Bionic Pancreas in Type 1 Diabetes. N Engl J Med 2014. doi:DOI: 10.1056/NEJMoa1314474 DOI
  33. Brown SA, Kovatchev BP, Raghinaru D, et al. Six-Month Randomized, Multicenter Trial of Closed-Loop Control in Type 1 Diabetes. N Engl J Med 2019; 381: 1707-17. pmid:31618560 PubMed
  34. Hussain MA, Theise ND. Stem-cell therapy for diabetes mellitus. Lancet 2004; 364: 203-5. PubMed
  35. Writing Committee for the Type 1 Diabetes TrialNet Oral Insulin Study Group . Effect of Oral Insulin on Prevention of Diabetes in Relatives of Patients With Type 1 Diabetes A Randomized Clinical Trial. JAMA 2017; 318: 1891-902. pmid:29164254 PubMed
  36. The Diabetes Virus Detection and Intervention Trial. Nettside besøkt 06.12.20. forskningsprosjekter.ihelse.net
  37. Toni G, Berioli MG, Cerquiglini L, et al. Eating Disorders and Disordered Eating Symptoms in Adolescents with Type 1 Diabetes. Nutrients. 2017;9(8):906. Published 2017 Aug 19. PMID: 28825608. PubMed
  38. Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group, Nathan DM, Zinman B, et al. Modern-day clinical course of type 1 diabetes mellitus after 30 years' duration: the diabetes control and complications trial/epidemiology of diabetes interventions and complications and Pittsburgh epidemiology of diabetes complications experience (1983-2005). Arch Intern Med 2009; 169:1307. PubMed
  39. Finne P, Reunanen A, Stenman S, Groop P-H, Grönhagen-Riska C. Incidence of end-stage renal disease in patients with type 1 diabetes. JAMA 2005; 294: 1782-7. PubMed
  40. Gagnum V, Saeed M, Stene LC, et al. Low Incidence of End-Stage Renal Disease in Childhood-Onset Type 1 Diabetes Followed for Up to 42 Years.. Diabetes Care 2018; 41: 420-5. pmid:29025877 PubMed
  41. Lind M, Bounias I, Olsson M, et al. Glycaemic control and incidence of heart failure in 20985 patients with type 1 diabetes: an observational study. Lancet 2011; 378: 140-6. PubMed
  42. Lind M, Svensson A-M, Kosiborod M, et al. Glycemic Control and Excess Mortality in Type 1 Diabetes. N Engl J Med 2014; 371: 1972-82. doi:10.1056/NEJMoa1408214 DOI
  43. Matuleviciene-Anängen V, Rosengren A, Svensson AM, et al. Glycaemic control and excess risk of major coronary events in persons with type 1 diabetes. Heart 2017. pmid:28710186 PubMed
  44. Huxley RR, Peters SA, Mishra GD, Woodward M. Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2015;3:198-206. doi:10.1016/S2213-8587(14)70248-7 DOI
  45. Edwards J, Stapley S. Debridement of diabetic foot ulcers. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No.: CD003556. DOI: 10.1002/14651858.CD003556.pub2. DOI
  46. Larkin ME, Barnie A, Braffett BH, et al. Musculoskeletal Complications in Type 1 Diabetes. Diabetes Care. 2014 Apr 10.
  47. Juel NG, Brox JI, Brunborg C, et al. Very High Prevalence of Frozen Shoulder in Patients With Type 1 Diabetes of ≥45 Years' Duration: The Dialong Shoulder Study. Arch Phys Med Rehabil 2017; 98: 1551-9. pmid:28219686 PubMed
  48. Perkins BA, Ficociello LH, Silva KH. Regression of microalbuminuria in type 1 diabetes. N Engl J Med 2003; 348: 2285-93. pmid:12788992 PubMed
  49. Cooper MN, de Klerk NH, Jones TW, Davis EA.. Clinical and demographic risk factors associated with mortality during early adulthood in a population-based cohort of childhood-onset type 1 diabetes. Diabet Med 2014; 31(12): 1550-8. doi:10.1111/dme.12522 DOI
  50. Katz M, Laffel L. Mortality in type 1 diabetes in the current era. Two steps forward, one step backward. JAMA. 2015;313(1):35-36 . doi:10.1001/jama.2014.16327 DOI
  51. Orchard TJ, Secrest AM, Miller RG, Costacou T. In the absence of renal disease, 20 year mortality risk in type 1 diabetes is comparable to that of the general population. Diabetologia. 2010;53(11):2312-2319. PubMed
  52. Groop PH, Thomas MC, Moran JL, et al; FinnDiane Study Group. The presence and severity of chronic kidney disease predicts all-cause mortality in type 1 diabetes. Diabetes. 2009;58(7):1651-1658. PubMed
  53. Livingstone SJ, Levin D, Looker HC, et al. Estimated life expectancy in a Scottish cohort with type 1 diabetes, 2008-2010. JAMA. 2015;313(1):37-44. . doi:10.1001/jama.2014.16425 DOI
  54. DCCT/EDIC Research Group. Association between 7 years of intensive treatment of type 1 diabetes and long-term mortality. JAMA. doi:10.1001/jama.2014.16107. DOI
  55. Havas S, Donner T. Tight control of type 1 diabetes: Recommendations for patients. Am Fam Physician 2006; 74: 971-8. PubMed
  56. Abbasi J. Type 1 Diabetes Advances Could Pave Way for Prevention. Medical News & Perspectives. August 2019
  57. Julsrud Berg T. Diabetes mellitus. Norsk legemiddelhåndbok, sist endret 19.09.2018. www.legemiddelhandboka.no
Annonse
Annonse