Physiological Adaptation Q 50
A patient with newly diagnosed diabetes mellitus is learning to recognize the symptoms of hypoglycemia. Which of the following symptoms is indicative of hypoglycemia?
A. Polydipsia
B. Confusion
C. Blurred vision
D. Polyphagia
Correct Answer: B. Confusion
Hypoglycemia in diabetes mellitus causes confusion, indicating the need for carbohydrates. Neuroglycopenic signs and symptoms are signs and symptoms that result from direct central nervous system (CNS) deprivation of glucose. These include behavioral changes, confusion, fatigue, seizure, coma, and potential death if not immediately corrected.
Option A: Neurogenic signs and symptoms can either be adrenergic (tremor, palpitations, anxiety) or cholinergic (hunger, diaphoresis, paresthesias). Neurogenic symptoms and signs arise from sympathoadrenal involvement (either norepinephrine or acetylcholine release) in response to perceived hypoglycemia.
Option C: Patients with diabetes mellitus (DM) often experience subjective symptoms of blurred vision associated with hyperglycemia. The nature and origin of this phenomenon are still unclear. Blurred vision during hyperglycemia could be a result of transient refractive alterations due to changes in the lens, but it could also be caused by changes in the retina.
Option D: Polydipsia, blurred vision, and polyphagia are symptoms of hyperglycemia. Symptoms of severe hyperglycemia include polyuria, polydipsia, and weight loss. As the patient’s blood glucose increases, neurologic symptoms can develop. The patient may experience lethargy, focal neurologic deficits, or altered mental status. The patient can progress to a comatose state.