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      • From Wikipedia, the free encyclopedia Diabetic hypoglycemia is a low blood glucose level occurring in a person with diabetes mellitus. It is one of the most common types of hypoglycemia seen in emergency departments and hospitals.,of%20hypoglycemia%20seen%20in%20emergency%20departments%20and%20hospitals.
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  2. Hypoglycemia - Wikipedia

    Hypoglycemia, also known as low blood sugar, is a fall in blood sugar to levels below normal. This may result in a variety of symptoms, including clumsiness, trouble talking, confusion, loss of consciousness, seizures, or death. Feelings of hunger, sweating, shakiness, or weakness may also be present. Symptoms typically come on quickly. The most common cause of hypoglycemia is medications used to treat diabetes such as insulin and sulfonylureas. Risk is greater in diabetics who have eaten less t

    • Signs and symptoms

      Hypoglycemic symptoms and manifestations can be divided into...

    • Causes

      The most common cause of hypoglycemia is medications used to...

    • Pathophysiology

      Like most animal tissues, brain metabolism depends primarily...

    • Diagnosis

      The glucose level that defines hypoglycemia is variable. In...

    • Prevention

      The most effective methods of preventing further episodes of...

  3. Diabetic hypoglycemia - Wikipedia

    From Wikipedia, the free encyclopedia Diabetic hypoglycemia is a low blood glucose level occurring in a person with diabetes mellitus. It is one of the most common types of hypoglycemia seen in emergency departments and hospitals.

    • Insulin reaction, Insulin shock
  4. From Wikipedia, the free encyclopedia Hypoglycemia is a medical emergency that involves lower than normal blood sugar. Normal blood sugar is about 70 to 100mg per deciliter. All of the cells in the body need sugar to do their jobs and to survive.

  5. Reactive hypoglycemia - Wikipedia
    • Overview
    • Signs and symptoms
    • Causes
    • Treatment
    • Postprandial syndrome

    Reactive hypoglycemia, postprandial hypoglycemia, or sugar crash is a term describing recurrent episodes of symptomatic hypoglycemia occurring up to four hours after a high carbohydrate meal in people with and without diabetes. The term is not necessarily a diagnosis since it requires an evaluation to determine the cause of the hypoglycemia. The condition is related to homeostatic systems used by the body to control the blood sugar level. It is described as a sense of tiredness, lethargy, irrita

    Symptoms vary according to individuals' hydration level and sensitivity to the rate and/or magnitude of decline of their blood glucose concentration. A crash is usually felt within four hours of heavy carbohydrate consumption. Along with the symptoms of hypoglycemia, symptoms of reactive hypoglycemia include: double vision or blurry vision unclear thinking brain fog insomnia heart palpitation or fibrillation fatigue dizziness light-headedness sweating headaches depression nervousness muscle twit

    The NIH states: "The causes of most cases of reactive hypoglycemia are still open to debate. Some researchers suggest that certain people may be more sensitive to the body’s normal release of the hormone epinephrine, which causes many of the symptoms of hypoglycemia. Others believe deficiencies in glucagon secretion might lead to reactive hypoglycemia. Several other hormones are responsible for modulating the body's response to insulin, including cortisol, growth hormone and sex hormones ...

    Reactive hypoglycemia can usually be relieved by dietary changes: 1. Avoiding or limiting sugar intake, including candy, sweet desserts, fruit juice, and drinks with added sugar. 2. Eating only small amounts of starchy foods, including potatoes, pasta, breakfast cereals, and rice. 3. Eating a variety of foods, including: eggs, nuts, dairy products, tofu, beans, lentils, meat, poultry, fish, or other sources of protein with every meal or snack, whole-grain carbohydrates, such as eating whole whea

    If there is no hypoglycemia at the time of the symptoms, this condition is called idiopathic postprandial syndrome. It might be an "adrenergic postprandial syndrome" — blood glucose levels are normal, but the symptoms are caused through autonomic adrenergic counterregulation. Often, this syndrome is associated with emotional distress and anxious behaviour of the patient. This is often seen in dysautonomic disorders as well. Dietary recommendations for reactive hypoglycemia can help to ...

    • Low-carbohydrate diet, frequent small meals
    • Within 4 hours of a high carbohydrate meal
  6. Neonatal hypoglycemia - Wikipedia
    • Overview
    • Signs and symptoms
    • Effects of neonatal hypoglycemia
    • Cause
    • Mechanism
    • Diagnosis

    Neonatal hypoglycemia occurs when the neonate's blood glucose level is less than the newborn's body requirements for factors such as cellular energy and metabolism. There is inconsistency internationally for diagnostic thresholds. In the US, hypoglycemia is when the blood glucose level is below 30 mg/dl within the first 24 hours of life and below 45 mg/dl thereafter. In the UK, however, lower and more variable thresholds are used. The neonate's gestational age, birth weight, metabolic needs, and

    The way in which neonatal hypoglycemia symptoms may be presented is vague or hard to tell apart from other conditions. The symptoms can be confused with

    Infants that experienced hypoglycemic episodes requiring treatment within the first few days of life have a higher chance of developing neurological or neurodevelopmental diagnoses than normoglycemic infants. The severity of the effects resulting from the hypoglycemic episode depend on the length of the hypoglycemic episode and how low the neonate's blood glucose levels drop during the episode. Because glucose is an essential nutrient for the brain, untreated neonatal hypoglycemia causes irrever

    Risk factors in the mother that increased the risk of developing hypoglycemia shortly after birth include

    The most common cause on neonatal hypoglycemia is hyperinsulinism. Hyperinsulinism is also called persistent hyperinsulemic hypoglycemia of infancy. This is seen very frequently to the neonates born from mothers with diabetes. Congenital hyperinsulinism is correlated with the abn

    Limited glycogen storage occurs in premature newborns or newborns that had intrauterine growth retardation.

    There are many types of hypoglycemia, including transient and reoccurring. Each is associated with different risk factors and may have many underlying causes. Neonatal hypoglycemia occurs because an infants brain is dependent on a healthy supply of glucose. During the last trimester of pregnancy, glucose is stored in the liver, heart, and skeletal muscles. All newborns experience a physiological and transient fall in blood glucose, reaching a nadir at 2–3 hours of age before slowly rising ...

    Screening for hypoglycemia is done on every neonate on admission in the USA but this is not recommended practice in all developed countries. One way of screening includes a heel stick to test the blood glucose level at the bedside. Diagnosing hypoglycemia in neonates requires two consecutive blood glucose readings of less than 40 mg/dl to properly diagnose hypoglycemia. Bedside glucose monitoring is only effective if the equipment is accurate, rapid, and reliable. This form of testing is often f

    • Hyperinsulinism, limited glycogen stores, increases glucose use, decreased gluconeogenesis, depleted glycogen stores
    • Maternal-Gestational diabetes, eclampsia, drug use. Neonate- small for gestational age, inadequate feeding, respiratory distress
    • Blood sample
    • 40% dextrose gel, 10% dextrose influsion, early breastfeeding
  7. Hypoglycemia - WikEM
    • Clinical Features
    • Evaluation
    • Management
    • Disposition
    • See Also


    1. Altered mental status, lethargy, confusion 2. Focal neurologic deficits, visual disturbances 3. Seizure 4. Unresponsiveness


    1. Glucose levels < 55 mg/dL cause catecholamine surge 2. Anxiety, nervousness, irritability 3. Nausea and vomiting 4. Palpitations 5. Tremor 6. Changes in pupil size 7. Tachycardia or bradycardia 8. Salivation


    1. Patients with known diabetes who are not systemically ill and can identify a clear precipitant, no extensive workup is required. 2. In severely ill patients, consider: 2.1. BMP 2.2. LFT 2.3. EtOH 2.4. Infectious workup: CXR, UA, urine and blood cultures 2.5. ECG, troponin 2.6. Other studies (not normally done in ED): insulin, C-peptide, pro-insulin, glucagon, growth hormone, cortisol, B-OH, insulin antibodies 2.6.1. Exogenous insulin shows suppressed C-peptide levels (artificial insulin do...


    "Whipple's Triad" 1. Symptoms suggestive of hypoglycemia 1.1. See Clinical Features 2. Low glucose 2.1. Serum glucose <60mg/dL 2.2. Generally symptomatic at <55mg/dL though threshold is variable depending on chronicity 3. Resolution of symptoms after administration of glucose

    If awake and able to tolerate POs
    If altered mental status or otherwise unable to tolerate POs

    Admission or observation for oral anti-hyperglycemic agent or intermediate- to long-acting insulin. Consider discharge after 4h uneventful observation if: 1. Hypoglycemiafully and rapidly reversed without continuous infusion of dextrose 2. Tolerated a full meal in ED 3. Clear and innocuous cause identified with recurrence unlikely 4. Adequate patient understanding, home support/monitoring, and ability to detect/prevent recurrence with close primary care follow-up

  8. Ketotic hypoglycemia - Wikipedia
    • Overview
    • Presentation
    • Cause
    • Natural history
    • Diagnosis
    • Treatment

    Ketotic hypoglycemia is a medical term used in two ways: broadly, to refer to any circumstance in which low blood glucose is accompanied by ketosis, and in a much more restrictive way to refer to recurrent episodes of hypoglycemic symptoms with ketosis and, often, vomiting, in young children. The first usage refers to a pair of metabolic states that can have many causes, while the second usage refers to a specific "disease" called ketotic hypoglycemia. Ketotic hypoglycemia more commonly refers t

    The typical patient with ketotic hypoglycemia is a young child between the ages of 10 months and 4 years. Episodes nearly always occur in the morning after an overnight fast, often one that is longer than usual. Symptoms include those of neuroglycopenia, ketosis, or both. The neuroglycopenic symptoms usually include lethargy and malaise, but may include unresponsiveness or seizures. The principal symptoms of ketosis are anorexia, abdominal discomfort, and nausea, sometimes progressing to vomitin

    There are hundreds of causes of hypoglycemia. Normally, the defensive, physiological response to a falling blood glucose is reduction of insulin secretion to undetectable levels, and release of glucagon, adrenaline, and other counterregulatory hormones. This shift of hormones initiates glycogenolysis and gluconeogenesis in the liver, and lipolysis in adipose tissue. Lipids are metabolized to triglycerides, in turn to fatty acids, which are transformed in the mitochondria of liver and kidney cell

    Children "outgrow" ketotic hypoglycemia, presumably because fasting tolerance improves as body mass increases. In most the episodes become milder and more infrequent by 4 to 5 years of age and rarely occur after age 9. Onset of hypoglycemia with ketosis after age 5 or persistence after age 7 should elicit referral and an intensive search for a more specific disease.

    The diagnosis is based on a combination of typical clinical features and exclusion by a pediatric endocrinologist of other causes of "hypoglycemia with ketosis," especially growth hormone deficiency, hypopituitarism, adrenal insufficiency, and identifiable inborn errors of metabolism such as organic acidoses. The most useful diagnostic tests include measurement of insulin, growth hormone, cortisol, and lactic acid at the time of the hypoglycemia. Plasma acylcarnitine levels and urine organic aci

    Once ketotic hypoglycemia is suspected and other conditions excluded, appropriate treatment reduces the frequency and duration of episodes. Extended fasts should be avoided. The child should be given a bedtime snack of carbohydrates and should be awakened and fed after the usual duration of sleep. If the child is underweight, a daily nutritional supplement may be recommended. Raw cornstarch dissolved in a beverage helps individuals with hypoglycemia, especially that caused by Glycogen Storage Di

  9. Dysglycemia - Wikipedia

    Hypoglycemia. Hypoglycemia is a fall in blood sugar to levels below normal. This may result in a variety of symptoms including clumsiness, trouble talking, confusion, loss of consciousness, seizures or death. A feeling of hunger, sweating, shakiness and weakness may also be present. Symptoms typically come on quickly.

  10. Hyperglycemia - Wikipedia
    • Overview
    • Signs and symptoms
    • Causes
    • Diagnosis
    • Treatment
    • Etymology

    Hyperglycemia is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a blood sugar level higher than 11.1 mmol/l, but symptoms may not start to become noticeable until even higher values such as 13.9–16.7 mmol/l. A subject with a consistent range between ~5.6 and ~7 mmol/l is considered slightly hyperglycemic, and above 7 mmol/l is generally held to have diabetes. For diabetics, glucose levels that are considered to be too hyperglycemic...

    The degree of hyperglycemia can change over time depending on the metabolic cause, for example, impaired glucose tolerance or fasting glucose, and it can depend on treatment. Temporary hyperglycemia is often benign and asymptomatic. Blood glucose levels can rise well above normal and cause pathological and functional changes for significant periods without producing any permanent effects or symptoms. During this asymptomatic period, an abnormality in carbohydrate metabolism can occur which can b

    Chronic hyperglycemia that persists even in fasting states is most commonly caused by diabetes mellitus. In fact, chronic hyperglycemia is the defining characteristic of the disease. Intermittent hyperglycemia may be present in prediabetic states. Acute episodes of hyperglycemia

    Obesity has been contributing to increased insulin resistance due to the population's daily caloric intake rising. Insulin resistance increases hyperglycemia because the body becomes over saturated by glucose. Insulin resistance desensitizes insulin receptors, preventing insulin

    Certain medications increase the risk of hyperglycemia, including corticosteroids, octreotide, beta blockers, epinephrine, thiazide diuretics, statins, niacin, pentamidine, protease inhibitors, L-asparaginase, and antipsychotics. The acute administration of stimulants such as amp

    It is critical for patients who monitor glucose levels at home to be aware of which units of measurement their testing kit uses. Glucose levels are measured in either

    Treatment of hyperglycemia requires elimination of the underlying cause, such as diabetes. Acute hyperglycemia can be treated by direct administration of insulin in most cases. Severe hyperglycemia can be treated with oral hypoglycemic therapy and lifestyle modification. Replacing white bread with whole wheat may help reduce hyperglycemia In diabetes mellitus, treatment aims at maintaining blood glucose at a level as close to normal as possible, in order to avoid serious long-term complications.

    The origin of the term is Greek: prefix ὑπέρ- hyper- "over-", γλυκός glycos "sweet wine, must", αἷμα haima "blood", -ία, -εια -ia suffix for abstract nouns of feminine gender.

    • High blood sugar, hyperglycaemia, hyperglycæmia
  11. Hypoglycemia - Symptoms and causes - Mayo Clinic
    • Overview
    • Symptoms
    • Causes
    • Complications
    • Prevention

    Hypoglycemia is a condition caused by a very low level of blood sugar (glucose), your body's main energy source.Hypoglycemia is often related to the treatment of diabetes. However, a variety of conditions — many rare — can cause low blood sugar in people without diabetes. Like fever, hypoglycemia isn't a disease itself — it's an indicator of a health problem.Immediate treatment of hypoglycemia is necessary when blood sugar levels are at 70 milligrams per deciliter (mg/dL) or 3.9 millimoles pe...

    If blood sugar levels become too low, signs and symptoms may include: 1. An irregular heart rhythm 2. Fatigue 3. Pale skin 4. Shakiness 5. Anxiety 6. Sweating 7. Hunger 8. Irritability 9. Tingling sensation around the mouth 10. Crying out during sleepAs hypoglycemia worsens, signs and symptoms may include: 1. Confusion, abnormal behavior or both, such as the inability to complete routine tasks 2. Visual disturbances, such as blurred vision 3. Seizures 4. Loss of consciousnessPeople with sever...

    Hypoglycemia occurs when your blood sugar (glucose) level falls too low. There are several reasons why this may happen, the most common is a side effect of drugs used to treat diabetes.

    If you ignore the symptoms of hypoglycemia too long, you may lose consciousness. That's because your brain needs glucose to function properly.Recognize the signs and symptoms of hypoglycemia early because untreated hypoglycemia can lead to: 1. Seizure 2. Loss of consciousness 3. DeathHypoglcemia can also contribute to: 1. Falls 2. Injuries 3. Motor vehicle accidents

    1. If you have diabetes, carefully follow the diabetes management plan you and your doctor have developed. If you're taking new medications, changing your eating or medication schedules, or adding new exercise, talk to your doctor about how these changes might affect your diabetes management and your risk of low blood sugar. A continuous glucose monitor (CGM) is an option for some people, particularly those with hypoglycemia unawareness. These devices insert a tiny wire under the skin that c...

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