Case 1 - Hypoglycaemia Flashcards

1
Q

Presentation of hypoglycaemia

A
  • Autonomic - pallor, sweating, tremor, tachycardia, tingly lips, convulsions
  • Neuro - decreased conc, behavioural change
  • Sometimes none if hypoglycaemia unawareness
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2
Q

Managing hypoglycaemia

A
  • A-E
  • IV access

If mild - ie conscious and able to swallow:
* Glucojuice
* Lift juice shot
* 5-7 dextrose tablets

If able to swallow but bit disorientated:
* 2 tubes glucose gel

If no response in 40mins or after 3 treatment cycles:
* IM glucagon or 50ml of 20% glucose

If unconcious/aggressive/NBM or BG less than 2.6, start with severe management - 100ml 20% glucose over 10-15 minutes

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3
Q

After immediate treatment what further steps should be taken?

A
  • Test CBG every 10 mins
  • If remains less than 4mmol follow treatment plan
  • Once above 4mmol/L and conscious and able to swallow give long acting carbohydrate eg cereal, biscuits, yoghurt
  • Restart insulin once above 4mmol/L
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4
Q

Algorithm for treatment of hypoglycaemia

A
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5
Q

Reasons for recurrent hypoglycaemia

A
  • Reduced oral intake
  • Not eating enough
  • Postponing or meal skipping
  • Too much insulin given
  • Drinking alcohol
  • Increasing exercise without adjusting medication
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6
Q

What is meant by multiple daily injection basal bolus insulin regime with 1:10 QA to carb ratio?

A
  • Multiple daily injections
  • Basal - long acting insulin
  • Bolus - fast acting insulin
  • 1:10 - how much bolus insulin to give per gram of carb, eg 60g carbs give 6 units bolus insulin
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7
Q

Example of long acting insulin

A
  • Lantus
  • Tresiba
  • Insulatard
  • Humulin I
  • Levemir
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8
Q

Examples of short acting insulin

A
  • Novorapid
  • Humalog
  • Apidra
  • Actrapid
  • Humulin S
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9
Q
A
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