HYPOGLYCEMIA

 

Etiology:

  1. Iatrogenic 2ry to insulin or oral hypoglycemic
     
  2. ETOH, ASA, Sulfa-based medications, b-blockers
     
  3. Symogi phenomena (nocturnal hypoglycemia 2ry to excess insulin with rebound hyperglycemia)
     
  4. Post-prandial, post-gastrectomy, CRF, liver failure.

S & S:

  1. CNS : sz, lethargy,
     
  2. CV : diaphoresis, normal BP, tachycardia.

DX:

  1. FS
     
  2. C-peptide (­ in ingestion of sulfonylureas and ¯  with insulin injection) 0 Check urine sulfonylureas

Treatment:

  1. D50
     
  2. Glucagone  0.5 - 2 mg IM, IV, SQ. Works in 10-20 min. Short T ½ when given IV.
     
  3. If pt developed hypoglycemia on insulin they can be discharged  after eating and being observed   for  few hrs. If  hypoglycemia developed on oral hypoglycemic, pt needs longer observation and possibly admission since T ½ is generally > 24 hrs, especially if renal failure.

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