Hypoglycaemia

Question 1

Name 2 types of hypoglycaemia.

Answer 1

1. Fasting hypoglycaemia

2. Post prandial hypoglycaemia

Question 2

Name the causes of fasting hypoglycaemia.

Answer 2

EX P L A I N

1. Exogenous drugs - insulin, oral hypoglycaemics, ACE-i, beta blockers
2. Pituitary diseases
3. Liver diseases (inability to breakdown glucagon)
4. Addisons disease
5. Insulinoma
6. Non-pancreatic neoplasms

Question 3

Name the causes of post prandial hypoglycaemia

Answer 3

1. Bariatric surgery
2. T2DM
   - -> Rapid increase in blood glucose –> rapid increase in insulin –> rapid decrease in blood glucose

Question 4

Name the common presentations of hypoglycaemia.

Answer 4

1. Tremors
2. Palpitations/tachycardia
3. Confusion
4. Behavioural change e.g. aggressiveness
5. Sweating
6. Seizures

Question 5

What suggest an insulinoma?

Answer 5

Whipple’s triad

1. Symptoms of hypoglycaemia
2. Low blood glucose level
3. Relieve of symptoms after glucose is raised

Question 6

What blood glucose level must patient be treated?

Answer 6

<4mmol/L

Question 7

What is the management plan for hypoglycaemia (if blood glucose <4mmol/L)?

Answer 7

1. 15g of fast acting carbohydrate
2. Measure blood glucose to make sure its above 4mmol/L
3. Give long acting carbohydrate e.g. high fibre starch to prevent recurrence