It is often desirable to obtain a baseline blood glucose measurement when detainees with diabetes are initially assessed and for this to be repeated if necessary throughout the detention period. All doctors should have the means to test blood glucose, using either a strip for visual estimation or a quantitative meter. Several small portable meters are now available.

Oral hypoglycemics and insulin should be continued and consideration given to supervision of insulin injections. Regular meals and snacks should be provided, and all patients with diabetes should have access to rapidly absorbed, carbohydrate-rich food.

Hypoglycemia is easily treated. If the blood glucose is less than 4 mmol/L in a conscious person, oral carbohydrates should be given. In a detainee who is unconscious or restless, an intravenous bolus of 50 mL of 50% dextrose solution may be difficult to administer and may result in skin necrosis if extravasation occurs; therefore, 1 mg of glucagon can be given intramuscularly, followed by 40% glucose gel orally or applied to the inside of the mouth. Glucagon can give an initial glycemic response even in a patient with alcoholic liver disease (13); however, it should be remembered that in severe alcoholics with depleted glycogen stores, the response to glucagon may be reduced or ineffective.

Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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