Iatrogenic Hypoglycaemia Flashcards
1
Q
Define hypoglycaemia
A
Clinical syndrome
BGL <3.3mmol/L
2
Q
What is the Whipple’s Triad?
A
- Hypoglycaemic symtpoms
- Low BGL
- Resolution of symptoms after increase blood glucose to normal
3
Q
Signs and symptoms of hypoglycaemia
A
- Nausea
- Confusion
- Palpitations
- Hunger
4
Q
Many causes of jypoglycaemia - name the big categories
A
- Excessive insulin
- Diabetic drugs
- GH or adrenal insufficiency
- Post-prandial hypo
- Insulinoma
- Large mesenchymal tumours
- Chronic liver disease
- Early pregnancy
- Congestive heart failure
- Autoimmune
5
Q
Diabetic drugs that can cause hypocglycaemia
A
- Sulfonylurea
- Meglitinide
- Synthetic insulin
6
Q
How do hypos happen with GH/adrenal insufficency
A
- Failure in response to hypos
7
Q
Those at risk of post prandial hypo
A
- Malnourished
- Alcoholics
8
Q
Where do insulinomas usually arise
A
From the pancreatic ductal or acinar cells (not islets)
- Unclear mechanism with insulin
9
Q
How do large mesenchymal tumours cause hypos
A
- Secrete IGF-2 - acts on insulin receptors - same effect
10
Q
Epidemiology - hyperinsulinaemic hypoglycaemia
A
- Rare
- More common with access to hypoagents
- More common in premature babies, low birth weight babies and people who have had a gastric bypass
11
Q
Epidemiology insulinoma
A
0.4/100 000
12
Q
Hypo treatment
A
- Dietary changes
- Supportive measures
- Insulinoma = surgery
13
Q
Complications of hypoglycaemia
A
- Seizures (CNS manifestation)
- Coma (low glucose to brain = focal neurological deficit and memory loss)
- Diabetes post-surgery
