Hypoglycaemia Flashcards
What is hypoglycaemia
A low blood sugar level (<4mmol/l)
What are the 4 problems associated with insulin?
- Immune response
- Local at injection site
- Weight gain (dose related)
- Hypoglycaemia (biggest problem & risk with insulin)
Why is immune response a problem with insulin?
Insulin resistance due to insulin signalling inhibition results in a series of immune response that worsen the inflammatory state (which causes diabetes) which then leads to hyperglycemia.
What are the 3 local/reactions at injection site?
- Lipohypertrophy (a lump of fatty tissue under your skin caused by repeated injections in the same place)
- Bruising/redness/scarring
- Rare allergic reactions
What are the signs and symptoms of MILD hypoglycaemia?
- Palpitations
- Tremor
- Hunger & sweating (adrenergic & lost if on beta-blockers)
- Perioral numbness & tingling
- Blurred vision
- Fatigue
- Headache
What are the signs and symptoms of MODERATE hypoglycaemia?
Behaviour change:
- Restlessness
- Agitation
- Irritability
- Drowsiness (but rousable)
- Confusion
- Slurred speech
What are the signs and symptoms of SEVERE hypoglycaemia?
- Very agitated/aggressive
- Unconscious
- Unresponsive
- Seizures
- Coma
What are the causes of Hypoglycaemia?
- Incorrect dosing of insulin at night time
- Delayed/missed meals
- Alcohol
- More exercise than usual
- Heat
- Stress
What is the recommended treatment for MILD hypoglycaemia?
15-20g rapidly absorbed sugar
- If necessary repeat after 10-15mins
- Taken after a snack/next meal of sustained carbohydrate
What is the recommended treatment for MODERATE hypoglycaemia?
- 1.5-2 tubes of GlucoGel or IM glucagon (1mg)
What is the recommended treatment for SEVERE hypoglycaemia?
- IM glucagon (1mg) or IV glucose (150ml of 10% over 10-15mins)
What should be the target blood glucose for hypoglycaemia patients?
Always to be >4mmol/l
