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Updated: Aug 14 2021


  • 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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