• Wed. Sep 28th, 2022

Hypoglycemia | Etiology | Treatment | QuadBloggers

hypoglycemia

Hypoglycemia is an etiological condition which has the following:

  • Initially, there is a decrease in plasma glucose levels to <2.5 – 3 mmol/l ( <50 mg/dl ) in the blood stream. Additionally, there are alterations of absolute blood glucose levels which causes the manifestation of the symptoms
  • Decidedly, Whipple’s triad can be used here to diagnose the disease. These include:
    • Initially, Symptoms that are significantly consistent with decreased sugar levels
    • Secondly, the Initial calculation of low plasma glucose concentration.
    • Finally, Relief of symptom

It is certainly seen commonly in cases of diabetes mellitus.

hypoglycemia

Etiology and causes of hypoglycemia:

Primarily, the disease has been observed in the following:

  • Patients who are taking medication for:
    • Critical illness :
      • Cardiac, hepatic and renal failure
      • Sepsis
      • Prolonged starvation
    • Drugs (In contrast to Alcohol consumption):
      • Insulin
      • Quinine
      • Quinolones
    • Hormone Deficiency :
      • Glucagon
      • Growth hormone
      • Cortisol
    • Mesenchymal tumors
  • Also, people who are fit and stable :
    • Exercise
    • Accidental or malicious
    • Endogenous hyperinsulinis
    • Pancreatic beta cell tumor
  • Insulin autoimmune hypoglycemia :
    • Antibody to insulin receptor
  • Functional beta cell disorders :
    • Post-gastric bypass hypoglycemia

Clinical features of hypoglycemia:

  • The main symptoms in patients are illustrated by the following in particular:
    • Palpitations
    • Tremors
    • Anxiety
    • Sweating
    • Hunger
    • Paresthesia
    • Behavioral changes
    • Confusion
    • Fatigue
    • Seizures
    • Loss of consciousness
    • Above all, Death if the condition is serious
  • Signs for example:
    • Tachycardia
    • Pallor
    • Cardiac arrhythmias
    • Last but not least, Increased systolic blood pressure

Diagnosis:

  • It should be noted that diagnosis is vital in cases of reduced blood glucose level and to prescribe appropriate treatment to the patients for stable maintenance of glucose levels.
  • The main parameters and investigations for diagnosis of diabetes should be as follows:
    • Firstly, Fasting blood glucose levels: A test on an empty stomach early in the morning
    • Secondly, Post prandial sugar: It should be performed after >1- 2 hours of consumption
    • Finally, Random blood glucose level
  • Frequently monitoring the insulin levels is mandated and it should be noted that the following tests are recommended:
    • Proinsulin
    • C-peptide
    • Sulfonylurea
    • Ethanol
    • Cortisol test
    • HbA1c
  • In addition to this, these test should be repeated subsequently every 3 months

Treatment:

Undoubtedly, we can use Acute management to treat the disease. These include:

  • Firstly, to continue the consumption of fruit juices ( rapidly absorbable sugar )
  • 5-10% Dextrose solution
  • Also, monitoring of glucose for 24 hours in cases of sulfonylurea
  • Treatment for the underlying factors that cause the disease
  • Emphasis on reducing the medication portion consumption to maintain normal blood glucose
  • In addition, we can use Diazoxide or octreotide therapy
  • Also, monitoring the Dietary intake

To conclude, please refer these books for a detailed description of the disease:

  • Harrisons book of internal medicine
  • Goldman cecil.
  • Davidsons essentials in conclusion

Also, please check out our other health related blogs here.

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