TREATMENT INDUCED HYPOGLYCEMIA Flashcards
What is hypoglycemia
Blood glucose<3.6
Hypoglycemia us more common in….
Elderly
Impaired renal function
Insulin
Long scting oral antidiabetics
Severe hypoglycemia
Bloof Glucose <2.2
Causes oh hypoglycaemia
Overdose of any anti-hyperglycaemic medication
Antihyperglycaemic medication use in renal impairment and the elderly
Omitted or inadequate amount of food
Unaccustomed physical over-activity
Excessive alcohol intake
Symptoms of hypoglycaemia
Dizziness
Blurred vision
Headaches
Palpitation
Sweating
Shaking of the hands and body
Unconsciousness
Convulsions
Irritability and abnormal behaviour especially in children
Signs of hypoglycaemia
Sweating
Tremors
Tachycardia and bounding pulse
Confusion
Unconsciousness
Convulsions
Signs of hypoglycaemia
Sweating
Tremors
Tachycardia and bounding pulse
Confusion
Unconsciousness
Convulsions
Investigations in hypoglycemia
Random blood glucose
Blood urea and electrolytes
Liver function tests
Non- pharmacologic management of mild hypoglycemia
2-3 teaspoons of granulated sugar or 3 cubes of sugar or ½ a bottle of soft drink (sugar-containing, not ‘diet’ drinks) to individuals who are conscious.
A glass of milk or fruit drink and a tablespoonful of honey are useful alternatives
The above measures should be followed immediately by a meal or snack
Non-pharmacological management of moderate hypoglycemia
Same as for mild hypoglycaemia, but repeat after 10 minutes.
If no improvement is observed, treat as for severe hypoglycaemia
First line management of Severe hypoglycemia
Dextrose, IV,
Adults
50% solution
25-50 ml over 1-3 minutes through a large vein
Then
5-10% solution
500 ml 4 hourly until the patient is able to eat normally
Children
10% solution
4 ml/kg body weight over 1-3 minutes through a large vein
Then
5% solution
According to total daily fluid requirement until blood glucose levels normalise
First line management of Severe hypoglycemia
Dextrose, IV,
Adults
50% solution
25-50 ml over 1-3 minutes through a large vein
Then
5-10% solution
500 ml 4 hourly until the patient is able to eat normally
Children
10% solution
4 ml/kg body weight over 1-3 minutes through a large vein
Then
5% solution
According to total daily fluid requirement until blood glucose levels normalise
Second line treatment of hypoglycemia
Glucagon, IV, IM or subcutaneous,
Adults
1 mg stat.
Children
8-18 years (bodyweight > 25 kg); 1 mg stat.
8-18 years (bodyweight < 25 kg); 500 micrograms stat.
1 month-8 years; 500 micrograms stat.
Neonate;
20 microgram/kg stat.
Second line treatment of hypoglycemia
Glucagon, IV, IM or subcutaneous,
Adults
1 mg stat.
Children
8-18 years (bodyweight > 25 kg); 1 mg stat.
8-18 years (bodyweight < 25 kg); 500 micrograms stat.
1 month-8 years; 500 micrograms stat.
Neonate;
20 microgram/kg stat.
