174 hypoglycemia Flashcards
when should hypoglycemia be considered a possibility?
confusion, altered consciousness, seizure
whipple’s triad
symptoms of hypoglycemia (neuro)
low plasma glucose measure precisely (not glucose monitor)
relief of symptoms when glucose is raised
defenses against low BG?
1 - lowers insulin
2 - increases glucaon
3 - increase Epi
later increases cortisol, GH
how long can liver glycogen maintain blood glucose levels?
~8 hrs
clinical manifestations of low BG?
diaphoresis, pallor
increased systolic BP
increased HR
confusion, LOC, death
adrenergic –> palpitations, tremor, anxiety
cholinergic –> sweating, hunger, paresthesias
causes of hypoglycemia in ill vs health people
ill - drugs, critical illness, hormone deficiencies, non-islet tumors
not ill - endogenous hyperinsulinim, autoimmune hypoglycemia
most common cause is DM
causes of hypoglycemia in ill vs health people
ill - drugs, critical illness, hormone deficiencies, non-islet tumors
not ill - endogenous hyperinsulinim, autoimmune hypoglycemia
most common cause is DM
what can cause low bg in DM?
insulin excess - wrong dose, skipping a meal, exercise, alcohol ingestions (blocks glucose production), renal failure (reduces insulin clearance)
what does ethanol do?
glocks gluconeogenesis but not glycogenolysis
renal failure
fails to clear insulin and reduced mobilization of gluconeogenesis precursors
sepsis
macrophages use glucose
primary insulinoma
beta-cell disorder
insulin keeps getting secreted even during low bg
dx - high insulin and C peptide during hypoglycemia
rx - surgery OR make diabetic via diazoxide
primary insulinoma
beta-cell disorder
insulin keeps getting secreted even during low bg
dx - high insulin and C peptide during hypoglycemia
rx - surgery OR make diabetic via diazoxide
rx for low bg
oral glucose/juice
IV glucose if not able to use oral
glucagon IM
