Updated: 8/14/2021

Hypoglycemia

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Introduction
  • Glucose less than about 50 mg/dL
  • Caused by
    • over-administration of insulin in type I diabetes
    • exercise in type I diabetes
    • less commonly induced by insulin secretagogues (e.g. sulfonylureas)
Presentation
  • Symptoms
    • adrenergic symptoms
      • sweating
      • anxiety
      • palpitation
      • mydriasis
      • numbness
      • tingling
    • arise 1-5 hours post-prandially
Treatment
  • Medical
    • carbohydrate intake (fruit juice)
    • glucagon IM injection
      • if unconscious
      • side effects include vomiting
Prognosis, Prevention, and Complications
  • Diabetic patients on β-blockers are at risk for severe hypoglycemia 
    • because early adrenergic symptoms do not present
    • sweating may be only sign (sweat glands are innervated by a cholinergic synapse despite sympathetic neuron)

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