Hypoglycemia Flashcards
what four things will increase with hypoglycemia?
glucagon
epi
growth hormone
cortisol
what goes down with hypoglycemia?
insulin
what level of sugar is quantified as true hypoglycemia?
less than 50
what are the autonomic symptoms of hypoglycemia?
diaphoresis shaky palpitations anxious parasthesia hungry
what are the neuroglycopenic symptoms of hypoglycemia?
weak/tired lack concentration dizzy blurred vision coma seizure
what is the hypoglycemia triad?
symptoms of hypoglycemia
confirmed lab result
resolution of symptoms with admin of glucose
if a neonate has hypoglycemia with high insulin, what four things can be considered?
insulinoma
maternal diabetes
congenital hyperinsulinism
drugs (insulin use)
what is congenital hyperinsuilinism?
mutation in K+ATPase
if adult has hypoglycemia and insulin is low…what are possible causes?
drugs
hormonal deficiency
critical illness
non islet cell tumors
how can non islet cell tumors produce low insulin hypoglycemia?
they secrete IGF-2 (insulin like growth factor), which can bind insulin receptors but is not measured in insulin measurements
what critical illnesses can cause hypoglycemia with low insulin?
liver failure
renal failure
sepsis
what two hormonal changes can cause hypoglycemia with low insulin?
low cortisol and growth hormone
what two drugs can cause low insulin hypoglycemia?
alcohol and slaicylates
what drug can cause high insulin hypoglycemia?
insulin and sulfonyureas
what tumor can cause high insuliin hypoglycemia?
insulinoma
what are the four measurements to make in hypoglycemia management?
glucose
insulin
C-peptide
sulfonylurea screen
how long is an observed fast to induce hypoglycemia?
72 hours max
what is C peptide?
pre insulin peptide…signal endogenous production of insulin
if C peptide is low but insulin is high…what do we think?
patient giving themselves insulin
if C peptide is high nd insulin is high…what do we think?
insulinoma
what happens to persons weight in insulinoma?
gain
does insulinoma induce hypoglycemia during postprandial or fasting time?
usually fasting
what is rx choice for insulinoma?
surgery
what are the 3 causes of postprandial hypoglycemia to be aware of?
postgastrectomy
occult diabetes
isiopathic postprandial syndrome
what test is administered to evaluate postprandial hypoglycemia?
mixed meal test
what is a mixed meal test?
give food and watch sugar…checking for hypoglycemia
what is pathophys of postgastrectomy causing hypoglycemia?
rapid gastric emptying and influx of carbs to intesting causes overproduction of incretins and more insulin release than needed
what is rx for postgastrectomy hypoglycemia?
small frequent meals
explain the pathophys behind occult diabetes causing postprandial hypoglycemia
delayed but exaggerated insulin response in early diabetes…so you dont get the early push of insulin but later on after meal you get more than usual and this induces hypoglycemia
what is rx for occult diabetes postprandial hypoglycemia
small meals
what is idiopathic postprandial syndrome?
symptoms of hypoglycemia develop at random times following meals…no identifiable causes
