Lipids Update Flashcards
Management of hypoglycaemia if the person is alert & orientated?
Oral carbohydrates - juice/sweets/sandwich
Management of hypoglycaemia in a drowsy/confused person?
Buccal glucose - gel sublingually
Think about IV access
Management of hypoglycaemia in an unconscious person?
IV access
50 mL 50% glucose
OR
100 mLs 20% glucose
What is the limit for clinically significant hypoglycaemia in a neonate?
<2.5 mmol/L
Symptoms of hypoglycaemia?
Adrenergic = tremors, palpitations, sweating Neuroglycopaenic = confusion, coma
How can C peptide be used to categorise hypoglycaemia?
Low insulin, low C-peptide = hypoinsulinaemic hypoglycaemia, something other than insulin is causing the hypo
High insulin, high C-peptide = hyperinsulinaemic hypoglycaemia, excess insulin production is causing the hypo
High insulin, low C-peptide = exogenous insulin
What are the ketone bodies found in babies?
3-hydroxybutyrate
Acetone
Acetoacetate
What does ketone bodies +++ and hypoglycaemia suggest?
Fatty acid oxidation defect
What are the 4 main inherited metabolic disorders in neonates?
Fatty acid oxidation disorders - no ketones produced
Glycogen storate disease type 1
MCADD
Carnitine disorders
What is Beckwith-Wiedemann syndrome?
Overgrowth of islet cells present at birth
How do sulphonylureas work?
Bind to ATP-sensitive potassium channel and make it close. Thus there is insulin release even when there is no ATP - hypos.
What is an insulinoma?
Small solitary adenoma producing insulin
Can be associated with MEN1
What is C-peptide?
A substance made in the pancreas - connects insulin parts.
Secreted in equimolar amounts to insulin.
What is post-prandial hypoglycaemia?
Can occur after gastric bypass
