Which of the following are complications of diabetes? (Select all that apply)

Choice A reason: Not checking blood sugar before exercise is dangerous for diabetic patients, as hypoglycemia can occur during physical activity due to increased glucose uptake by muscles. Monitoring ensures safe exercise, preventing severe hypoglycemia, which can cause seizures or unconsciousness, requiring immediate correction with glucose sources.

Choice B reason: Eating a snack if blood sugar is below 100 mg/dL before exercise is appropriate. Low blood sugar increases hypoglycemia risk during activity due to enhanced insulin sensitivity and glucose utilization. A carbohydrate snack stabilizes glucose levels, ensuring safe exercise and preventing adverse events.

Choice C reason: Carrying hard candy is a correct practice for diabetic patients to quickly treat hypoglycemia during exercise. Hard candy provides rapid-acting glucose, counteracting low blood sugar caused by increased muscle glucose uptake or insulin effects, preventing symptoms like shakiness or confusion.

Choice D reason: Including swimming as an exercise routine is appropriate for diabetes management. Aererobic exercise like swimming enhances insulin sensitivity, promotes glucose uptake by muscles, and improves cardiovascular health, helping maintain stable blood sugar levels without increasing hypoglycemia risk when properly monitored.

Choice A reason: Glargine is a long-acting insulin providing basal coverage, not suitable for acute diabetic ketoacidosis (DKA). DKA, indicated by confusion, flushing, and acetone breath, requires rapid correction of hyperglycemia and acidosis. Glargine’s slow onset cannot address acute metabolic decompensation effectively, making it inappropriate for this scenario.

Choice B reason: Regular insulin is short-acting, ideal for treating diabetic ketoacidosis, as indicated by confusion, flushing, and acetone breath. It rapidly lowers blood glucose and corrects acidosis by facilitating glucose uptake and inhibiting ketogenesis, addressing the acute metabolic crisis effectively through intravenous administration.

Choice C reason: NPH is an intermediate-acting insulin, unsuitable for acute DKA management. Its slower onset and prolonged action do not provide the rapid glucose and ketone correction needed in DKA, where confusion and acetone breath indicate severe metabolic acidosis requiring immediate intervention with short-acting insulin.

Choice D reason: Detemir, a long-acting insulin, is used for basal glucose control, not acute DKA. Its gradual onset does not address the urgent need to correct hyperglycemia and ketosis in a patient with confusion and acetone breath, which require rapid-acting insulin to stabilize metabolic derangements quickly.