hypoglycaemia & hypounawareness

Question 1

what are the classifications for levels 1, 2 & 3 hypoglycaemia?

Answer 1

level 1 = 3.9mmol/l or less
level 2 = <3mmol/l
level 3 = severe cognitive impairment requiring external assistance for recovery

Question 2

what are the symptoms of hypoglycaemia?

Answer 2

hunger, fatigue, anxiety, sweating

Question 3

what are the brain consequences of hypoglycaemia?

Answer 3

Cognitive dysfunction
Hemiparesis
Seizures
Coma
Psychological (fear of hypoglycaemia)

Question 4

what are the heart complication of hypoglycaemia?

Answer 4

MI
arrhythmia
cardiac failure

Question 5

what are the msk complications of hypoglycaemia?

Answer 5

Falls
Fractures
Joint dislocations
Driving accidents

Question 6

what are the circulatory complications of hypoglycaemia?

Answer 6

Inflammation
Blood coagulation abnormalities
Haemodynamic changes
Endothelial dysfunction

Question 7

what are the diabetes related risk factors for severe hypoglycaemia?

Answer 7

impaired hypoglycaemia awareness
counterregulatory failure
long duration of diabetes and/or insulin therapy
impaired renal function
autonomic neuropathy
genes
prior episodes

Question 8

what patient groups are at particular risk for severe hypoglycaemia?

Answer 8

preschool age
adolescence
elderly
comorbidities - e.g. coeliac, hypothyroidism, addison’s disease, renal failure, gastroparesis
low socioeconomic status
excessive alcohol consumption
use of cns-depressing agents
over-ambitious attitude (gives themselves too much insulin)

Question 9

when should patients on insulin exercise?

Answer 9

2 hours after eating

Question 10

what is the biggest comorbidity for severe hypoglycaemia?

Answer 10

addison’s disease