Hypoglycaemia****

Question 1

Under what glucose level is classed as hypoglycaemia?

Answer 1

<3 mmol/L

Question 2

What is it a common side effect of?

Other causes:

• How does alcohol cause a hypo?
• How does Addison’s disease cause a hypo?
• Insulinoma is a type of islet cell tumour. How does it cause a hypo?

Answer 2

Diabetes treatment - not the disease itself

Alcohol consumption causes an increase in insulin secretion, which leads to low blood sugar. - usually, 24 hrs after drinking

An insulinoma is a tumour of the pancreas that is derived from beta cells and secretes insulin.

It is a rare form of a neuroendocrine tumour.

Most insulinomas are benign in that they grow exclusively at their origin within the pancreas, but a minority metastasize.

Question 3

Other causes:

- Why does liver failure cause a hypo?

Answer 3

Impaired gluconeogenesis in the injured liver
Decreased uptake of insulin by the hepatocytes. This increases the insulin level in the peripheral blood resulting in hypoglycemia.

Question 4

S+S:

Autonomic response - 4

Neuroglycopenia - 7

Answer 4

Shakes
Palpitations
Nervous
Hunger

Tingling 
Numbness
Fatigue
Drowsiness
Confusion
Coma
Seizures

Question 5

Management:

If orientated:

• what can be given?
• how many times should this be done?
• once recovered from hypo, what can be given to maintain glucose level?

If confused but able to swallow:
- What type of gel can be inserted into their teeth and gums?

If unconscious or not responding to previous measures:

• What hormone can be given IM/SC if at home?
• What can be given at the hospital?

Once recovered they should be fed a long-acting carbohydrate. What food has this?

Answer 5

Slower release carbs once glucose > 4

Eat/drink 10-20 g of glucose (e.g. orange juice, small snack)

Up to 3 times

GlucoGel into the mouth
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Glucagon

A slice of toast