Hypoglycaemia

Question 1

What is the definition of hypoglycaemia? [2]

Answer 1

a low blood glucose level / defined as plasma glucose <3mmol/L

Question 2

What are the causes of hypoglycaemia in diabetics? [2]

Answer 2

1. chief cause is insulin or sulfonylurea treatment

2. increased activity, missed meal, accidental or non-accidental overdose

Question 3

What are the causes of hypoglycaemia in non-diabetics? [6]

Answer 3

1. exogenous drugs - insulin, oral hypoglycaemics, alcohol binge with no food, aspirin poisoning, ace inhibitors, beta-blockers
2. pituitary insufficiency
3. liver failure
4. Addison’s disease
5. islet cell tumours (insulinoma) and immune hypoglycaemia
6. non-pancreatic neoplasms

Question 4

What are the autonomic symptoms of hypoglycaemia? [6]

Answer 4

1. sweating
2. anxiety
3. hunger
4. tremor
5. palpitations
6. dizziness

Question 5

What are the neuroglycopenic symptoms of hypoglycaemia? [6]

Answer 5

1. hypoglycaemia can be mistaken for drunkenness
2. confusion
3. drowsiness
4. visual trouble
5. seizures
6. coma

Question 6

What is the treatment of hypoglycaemia? [4]

Answer 6

if conscious and able to swallow -

1. quick-acting carbohydrate/oral sugar (e.g. orange juice or glucose gel)
2. followed by long-acting carbohydrate (e.g. toast)

if unconscious or unable to swallow
3. 10% glucose IV
or
4. IM glucagon