[14] Hypoglycaemia Flashcards
What are the categories of symptoms of hypoglycaemia?
Autonomic
Neuroglycopenic
At what glucose levels do the autonomic symptoms of hypoglycaemia occur?
2.5-3
What are the autonomic symptoms of hypoglycaemia?
Sweating Anxiety Hunger Tremor Palpitations
At what glucose levels do the neuroglycopenic symptoms of hypoglycaemia occur?
<2.5
What are the neuroglycopenic symptoms of hypoglycaemia?
Confusion Drowsiness Seizures Personality change Focal neurology
At what glucose level does a hypoglycaemic coma occur?
<2.2
What diabetes medications cause fasting hypoglycaemia?
Usually insulin or sulphonylureas
Give 3 examples of when diabetes medications can cause hypoglycaemia
Exercise
Missed meal
Overdose
What are the causes of fasting hypoglycaemia in non-diabetics
Exogenous drugs Pituitary insufficiency Liver failure Addison's Islet cell tumours (insulinomas) Immune Other neoplasms
Give an example of an immune cause of fasting hypoglycaemia
Insulin receptor antibody production in Hodgkins lymphoma
Give an example of a non-pancreas neoplasm that can cause fasting hypoglycaemia
Fibrosarcomas
How is fasting hypoglycaemia investigated?
72 hour fast with monitoring
Blood tests
What is looked for in blood tests in fasting hypoglycaemia?
Glucose
Insulin
C-peptide
Ketones
What can cause hyperinsulinaemic hypoglycaemia?
Drugs
Insulinoma
What drug causes hyperinsulinaemic hypoglycaemia with raised C-peptide?
Sulphonylureas