HYPOGLYCEMIA KAMARUDDIN HASAN NASRUDDIN ABDUL RAHMAN 29/10/2009

INTRODUCTION Low blood sugar Commonest endocrine emergency Brain damage & death can occur in severe prolonged cases Can mimic any neurological presentation including coma, seizures, acute confusion or isolated hemiparesis. “ Always exclude hypoglycemia in any patient with coma, altered behaviour, neurological symptoms or signs.” OXFORD HANDBOOK OF ACCIDENT AND EMERGENCY MEDICINE, 2 ND EDITION

Low blood sugar

Commonest endocrine emergency

Brain damage & death can occur in severe prolonged cases

Can mimic any neurological presentation including coma, seizures, acute confusion or isolated hemiparesis.

“ Always exclude hypoglycemia in any patient with coma, altered behaviour, neurological symptoms or signs.”

DEFINITION Deficiency of glucose concentration in the blood which may lead to hypothermia, headache, and more serious neurological problems. Plasma glucose <3mmol/L Blood glucose < 3.5 mmol/L (63 mg/dl ) DORLAND’S POCKET MEDICAL DICTIONARY, 27 TH EDITION OXFORD HANDBOOK OF CLINICAL MEDICINE, 7 TH EDITION DAVIDSON’S PRINCIPLES AND PRACTICE OF MEDICINE, 20 TH EDITION

Deficiency of glucose concentration in the blood which may lead to hypothermia, headache, and more serious neurological problems.

Plasma glucose <3mmol/L

Blood glucose < 3.5 mmol/L (63 mg/dl )

TYPES OF HYPOGLYCEMIA POST-PRANDIAL HYPOGLYCEMIA FASTING HYPOGLYCEMIA DIABETIC NON-DIABETIC (EXPLAIN) Ex ogenous drugs P ituitary insufficiency L iver failure A ddison’s Disease I slet cell tumors N on-pancreatic neoplasms Insulin or sulfonylurea treatment Increase activity Missed meal Accidental/ non-accidental overdose Post-gastric surgery T2DM

SIGNS & SYMPTOMS American Diabetes Association lists the following as diabetic emergencies requiring first aid; UNCONCIOUSNESS TREMBLING EXCESSIVE SWEATING SUDDEN HUNGER CONFUSION DISORIENTATION PALE COLOR ANGER BAD TEMPER POOR COORDINATION SUDDEN ONSET SIGNS & SYMPTOMS

American Diabetes Association lists the following as diabetic emergencies requiring first aid;

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