hypoglycaemia

Question 1

what is it

Answer 1

blood glucose < 4.0mmol/L

Question 2

presentation

Answer 2

shaking/trembling
sweating
palpitations
hunger
headache
double vision / difficulty concentrating
slurred speech
confusion
coma

Question 3

causes

Answer 3

drugs eg insulin, sulphonylureas, GLP-1 analogues, DPP-4 inhibitors, Bbs, alcohol

acute liver failure

sepsis

adrenal insufficiency

insulinoma

Question 4

ivx

Answer 4

check medication history

serum insulin, C-peptide and proinsulin > to distinguish endogenous and exogenous

72 hour fast test > episodic hypo

8am cortisol > adrenal insufficiency

abdominal CT/MRI/PET > insulinoma

Question 5

mx of mild hypo

Answer 5

ABCDE

eat / drink 15-20mg fast acting Carbohydrate ie fruit juice NOT chocolate

eat a slow acting carb after