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emmedonline
Dr. Ajith Kumar J MD
Dept. of Emergency Medicne
Travancore Medicity, Kollam
India
editor
Hypoglyemia is defined when blood glucose levels are <63mg/dl.
Common causes & Risk Factors
Tight glycemic control
Missed, delayed or inadequate meals
Unexpected or unusual exercise
Alcohol
Errors in oral antidiabetic agent or insulin dose
Poor designed insulin regimen
Malbsorption disease
Gastroparesis
Lipohypertrophy at injection sites causing variable insulin absorption
Breastfeeding by diabetic mother
Unrecognised endocrine disorder eg: Addison's disease.
Previous history of severe hypoglycemia
Impaired awareness of hypoglycemia
Renal dialysis therapy
SYMPTOMS
Autonomic
Sweating
Trembling
Hunger
Anxiety
Pounding heart
Neuroglycopenic
Confusion
Drowsiness
Speech difficulty
Inability to concentrate
Incordination
Irritability, anger
Non specific
Nausea
Headache
Tiredness
Complication
CNS
Impaired cognitive function
Coma
Convulsion
TIA, Stroke
Brain damage
Focal neurological lesion
Heart
Cardiac arrythmia
Myocaridal ischaemia
Eye
Vitreous haemorrhage
Other
Accident
Hypothermia
MANAGEMENT
Oral fast acting carbohydrate (15– 20gm taken as glucose drink or tablets or confectionery followed by complex carbohydrate.
If the patient is semi-conscious or unconscious
75 ml of 20% dextrose (15 gm) ; In childrens gm/kg
Glucagon 1mg IM can also be used ; Childrens 0.5 mg IM.
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Updated on
22/10/2013
Reference
Davidson
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emmedonline
Dr. Ajith Kumar J MD
Dept. of Emergency Medicne
Travancore Medicity, Kollam
India
editor