Hypoglycaemia Flashcards
1
Q
How is hypoglycaemia defined?
A
- Commonest endocrine emergency
- Plasma glucose <3mmol/l
2
Q
What are the symptoms of hypoglycaemia?
A
- Autonomic:
- Sweating
- Anxiety
- Hunger
- Tremor
- Palpitations
- Dizziness
- Neuroglycopenic
- Confusion
- Drowsiness
- Visual troubble
- Seizures
- Coma
- Rarely focal symptoms
- Transient hemiplegia
- Mutism
- Personality change
- Restlessness
- Incoherence
- May lead to misdiagnosis of alcohol intoxication or even psychosis
3
Q
What are the causes of fasting hypoglycaemia?
A
- Insulin
- Sulphonylurea
- Increased activity
- Missed meals
- Accidental or non-accidental overdose
4
Q
What are the causes for fasting hypoglycaemia in non-diabetes?
A
EXPLAIN
-
Exogenous drugs - insulin or oral hypoglycaemia
- Body builders may misuse insulin to help stamina
- Alcohol binge with no food
- Aspirin poisoning
- ACEi
- Beta-blockers
- Pituitary insufficiency
- Liver failure
- Addisions disease
- Islet cell tumours (insulinoma)
- Non-pancreatic neoplasms
5
Q
What are the causes of hypoglycaemic hyperinsulinaemia?
A
- Insulinoma
- Sulfonlyureas
- Insulin injections
- Mutation in the insulin receptor gene
6
Q
What are the causes of hypoglycaemia when insulin is low or undetectable and there are no excess ketones?
A
- Non-pancreatic neoplasm
- Anti-insulin receptor antibodies
7
Q
What are the causes of hypoglycaemia when insulin is low and ketones are high?
A
8
Q
When is post-prandial hypoglycaemia most likely to occur?
A
9
Q
How is hypoglycaemia treated?
A
- If episodes are often advise the patient to have many small high starch meals
- if post-prandial decreased glucose, give slowly absorbing carbs (high fibre)
- In diabetics, rationalise insulin therapy
