Hypoglycaemia

 

Symptoms:

1. Tachycardia
2. Sweating
3. Confusion
4. Altered mentation
5. Dizziness
6. Unresponsiveness

Common Causes:

i. Alcohol consumption
ii. Liver failure
iii. Excessive intake of medications like paracetamol or aspirin
iv. Use of sulfonylureas (e.g., glyburide, glibenclamide)

Diagnosis:

Immediate Testing:
. Random Blood Glucose Level: A quick bedside glucose test to confirm hypoglycaemia.
Further Diagnostic Steps:
. Serum Insulin and C-peptide Levels: To differentiate between endogenous and exogenous insulin sources if necessary.
. Serum Electrolytes: To identify any associated electrolyte imbalances.

Whipple’s Triad:
. Low plasma glucose level (usually <4 mmol/L).
. Symptoms of hypoglycaemia (e.g., sweating, confusion, tachycardia).
. Resolution of symptoms upon correction of blood glucose levels.

 

Management of Hypoglycaemia

 

Condition	Management
Conscious and able to swallow	Give 200 ml of fruit juice
Conscious but unable to swallow	200 ml of 10% glucose IV OR 1 mg glucagon IM or SC
Unconscious	75 ml of 20% glucose IV OR 50 ml of 10% glucose IV OR 1 mg glucagon IM or SC