Hypoglycemia

Diagnosis

1. Symptoms consistent with the diagnosis
2. Symptoms associated with a low glucose level, usually <50
3. Symptoms resolve with glucose administration

DDX

1. Medication-induced
2. Sepsis
3. Toxin
4. Insulinoma
5. Hepatic failure
6. Adrenal insufficiency

Treatment

1. Hypoglycemia from insulin
   1. D50
   2. PO diet
   3. Glucagon
      1. Efficacy dependent on hepatic glycogen stores
      2. Onset of action slower than IV dextrose (7-10min)
      3. 1mg SC or IM
2. Hypoglycemia from sulfonylureas
   1. D50
   2. Octreotide
      1. Used to reduce risk of recurrent hypoglycemia
      2. 50-100mcg SC
   3. Do NOT use glucagon (stimulates insulin release)

Disposition

1. Consider admission for obs for sulfonylurea-induced hypoglycemia

See Also

• Diabetes Mellitus (Main)
• Hypoglycemia (Peds)
• Hypoglycemia (Neonatal)

Source

Tintinalli