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Bệnh nhân tiểu đường nên ăn uống bình thường và dùng liều lượng thông thường của insulin hoặc đại lý hạ đường huyết uống trước khi bất kỳ kế hoạch điều trị nha khoa. Nếu thức ăn được bỏ qua sau khi có insulin, đường huyết sẽ giảm xuống một mức độ thấp (hạ đường huyết). Điều này thường được xác định khi đường máu | MEDICAL EMERGENCIES AND RESUSCITATION This might usefully be administered while waiting for ambulance treatment but the decision to do this will depend on individual circumstances. Hypoglycaemia Patients with diabetes should eat normally and take their usual dose of insulin or oral hypoglycaemic agent before any planned dental treatment. If food is omitted after having insulin the blood glucose will fall to a low level hypoglycaemia . This is usually defined as a blood glucose 3.0 mmol per litre but some patients may show symptoms at higher blood sugar levels. Patients may recognise the symptoms themselves and will usually respond quickly to glucose. Children may not have such obvious features but may appear lethargic. Symptoms and signs Shaking and trembling. Sweating. Headache. Difficulty in concentration vagueness. Slurring of speech. Aggression and confusion. Fitting. Unconsciousness. Treatment The following staged treatment protocol is a suggested depending on the status of the patient. If any difficulty is experienced or the patient does not respond the ambulance service should be summoned immediately ambulance personnel will also follow this protocol. Confirm the diagnosis by measuring the blood glucose. Early stages - where the patient is co-operative and conscious with an intact gag reflex give oral glucose sugar sucrose milk with added sugar glucose tablets or gel . If necessary this may be repeated in 10 -15 minutes. In more severe cases - where the patient has impaired consciousness is uncooperative or is unable to swallow safely buccal glucose gel and or glucagon should be given. Glucagon should be given via the IM route 1mg in adults and children 8 years old or 25 kg 0.5mg if 8 years old or 25 kg . Remember it may take 5-10 minutes for glucagon to work and it requires the patient to have adequate glucose stores. Thus it may be ineffective in anorexic patients alcoholics or some non-diabetic patients. Re-check blood glucose after 10 minutes to ensure .
