Hypoglycaemia

Question 1

What is it defined as?

Answer 1

Plasma glucose <3mmol/L

Question 2

What are the causes in diabetics?

Answer 2

insulin or sulphonylurea treatment

Increased activity, missed meals, overdose

Question 3

What are the non-diabetic causes of hypoglycaemia?

Answer 3

EXPLAIN:
Ex - exogenous drugs - insulin, oral hypoglycaemics, alcohol binge, no food
P - pituitary insufficiency
L - liver failure
A - Addisons disease
I - Islets cell tumour + immune hypoglycaemia
N - non-pancreatic neoplasm

Question 4

How does someone with hypoglycaemia present?

Answer 4

1. Autonomic - sweating, anxiety, hunger, tremor, palpitations, dizziness
2. Neuroglycopenic - confusion, drowsiness, visual trouble, seizures, coma

Question 5

How is a diagnosis of hypoglycaemia mad?E

Answer 5

1 Fingerpick blood

2. Drug Hx - exclude liver failure
3. bloods - glucose, insulin, C-peptide, plasma ketones

Question 6

What is the treatment of hypoglycaemia?

Answer 6

1. If conscious, orientated + able to swallow - 15-20g of quick acting carb snack + recheck BM after 10-15mins
2. Uncooperative - glucose gel
3. Unconscious or above failed - glucose IVI or glucagon 1mg IV/IM