Hypoglycemia | Etiology | Treatment | QuadBloggers

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.

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

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.