Hypoglycemia medical therapy: Difference between revisions
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* Hypoglycemia due to hormone deficiencies such as [[hypopituitarism]] or [[adrenal insufficiency]] usually ceases when the appropriate hormone is replaced. | * Hypoglycemia due to hormone deficiencies such as [[hypopituitarism]] or [[adrenal insufficiency]] usually ceases when the appropriate hormone is replaced. | ||
* Patients with diabetes history who has loss of consciousness and there is no method to determine nature of coma; hypoglycemi or hyperglycemia,then glucose should be given empirically. This will correct hypoglycemia and will not be particularly dangerous if blood glucose concentration is high. | * Patients with diabetes history who has loss of consciousness and there is no method to determine nature of coma; hypoglycemi or hyperglycemia,then glucose should be given empirically. This will correct hypoglycemia and will not be particularly dangerous if blood glucose concentration is high. | ||
=== Postprandial hypoglycemia === | |||
* Frequent (every three hours) small meals or snacks. | |||
* Foods high in fiber, avoiding foods high in sugar. | |||
* Regular exercise regimen have been recommended [1,2]. | |||
==References== | ==References== |
Revision as of 16:10, 14 July 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy
Asymptomatic
- Cases with blood glucose of ≤70 mg/dL with regular monitoring.
- Repeating the measurement in short time
- Avoiding critical tasks
- Ingesting carbohydrates
- adjusting the regimen to avoid other attacks.
Symptomatic
- Patients should have source of carbohydrates available all times.
- 20 grams is usually sufficient to raise the blood glucose.
- In patients taking alpha-glucosidase inhibitor (acarbose), only dextrose should be used to treat hypoglycemia becuase acarbose slowes digestion of carbohydrates.
Severe
- A subcutaneous or intramuscular injection of 0.5 to 1.0 mg of glucagon will correct hypoglycemia within 15 minutes.
- If failed this attempt or in severe cases, 25% or 50% dextrose intravenously (IV) followed by subcutaneous glucose.
- If these measures aren't available:
- Squeezing a glucose gel in the space between the teeth and buccal mucosa with patient head tilted on side to prevent aspiration.
- If glucose gel isn't available, putting table sugar under the tongue may save patient. [57,58]
- Hypoglycemia due to hormone deficiencies such as hypopituitarism or adrenal insufficiency usually ceases when the appropriate hormone is replaced.
- Patients with diabetes history who has loss of consciousness and there is no method to determine nature of coma; hypoglycemi or hyperglycemia,then glucose should be given empirically. This will correct hypoglycemia and will not be particularly dangerous if blood glucose concentration is high.
Postprandial hypoglycemia
- Frequent (every three hours) small meals or snacks.
- Foods high in fiber, avoiding foods high in sugar.
- Regular exercise regimen have been recommended [1,2].