EMmedonline

• 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.

Updated on

• 22/10/2013

Reference

• Davidson