2(E): Hypoglycaemia Flashcards
What is the commonest endocrine emergency
Hypoglycaemia
What defines hypoglycaemia
<3mmol/L
What is the most common cause of hypoglycaemia in diabetics
Over-use of insulin and sulphonylureas
What is mnemonic to remember cause of hypoglycaemia in non-diabetics
EXPLAIN
EXogenous medications Pituitary insufficiency Liver failure Addison's disease Islet cell tumour (Insulinoma) Non-pancreatic neoplasms
What exogenous drugs can cause hypoglycaemia
- B-blocker
- Alcohol
- Aspirin poisoning
- ACEi
- Quinine
What non-pancreatic neoplasm can cause hypoglycaemia
Fibrosarcoma
When may post-prandial hypoglycaemia occur
Following bariatric surgery
When do symptoms of hypoglycaemia usually onset
Glucose <2.6mmol/L
What are the autonomic symptoms of hypoglycaemia
Increase sympathetic activity:
- Tachycardia
- Sweating
- Pallour
- Anxiety
What are neuroglycopenic symptoms
- Agitation
- Confusion
- Behavioural change
- Seizures
What is first line investigation for hypoglycaemia
Capillary blood glucose
When should non-diabetics be investigated for hypoglycaemia
- Signs and Symptoms of low glucose
- Low plasma glucose
- Resolution of symptoms following glucose rise
What may be ordered in hypoglycaemia
Lab Glucose
Insulin
C-Peptide
How is hypoglycaemia managed if conscious
If conscious and able to swallow give 15-20g of carbohydrate snack and measure blood glucose in 15m
How is hypoglycaemia managed if patient is conscious but not co-operative
Glucogel
