Ricardo was diagnosed with type I diabetes. The nurse is aware that acute hypoglycemia also can develop in the client who is diagnosed with:
A. Liver disease
B. Hypertension
C. Type 2 diabetes
D. Hyperthyroidism
Correct Answer: A. Liver Disease
The client with liver disease has a decreased ability to metabolize carbohydrates because of a decreased ability to form glycogen (glycogenesis) and to form glucose from glycogen.
Option B: The hemodynamic changes associated with hypoglycemia include an increase in heart rate and peripheral systolic blood pressure, a fall in the central blood pressure, reduced peripheral arterial resistance, and increased myocardial contractility, stroke volume, and cardiac output.
Option C: Type 2 diabetes is an islet paracrinopathy in which the reciprocal relationship between the glucagon-secreting alpha cell and the insulin-secreting beta-cell is lost, leading to hyperglucagonemia and hence the consequent hyperglycemia.
Option D: Hyperthyroidism is usually associated with poor blood glucose control and a need for additional insulin. An increased metabolism “clears” insulin from the system at a faster rate, and increased production and absorption of glucose can raise blood sugars.