Hypoglycemia

< 70 mg/dl of CBG

Diagnosis

• Based on CBG

Mng

Goal

Raise >70mg/dl CBG

Watch for Rebound Hypoglycemia

• Concious patient = Oral / iv glucose

• Unconcoius patient

  • 50% DNS 50ml bolus X 2 times gives 25 grams of glucose
  • CBG = 70mg/dl ⇒ gain Conciousness then Give oral long acting glucose

  • Still unconcious even >70mg/dl

    • start 5%-10%DNS and maintain > 100mg/dl CBG
      • No Respone to 50% DNS 2 times => other causes of hypoglycemia, such as sepsis, toxin, insulinoma, hepatic failure, or adrenal insufficiency.
    • Check CBG for Rebound Hypoglycemia every 30min for 2hrs

• Glipizide, glimipride induced Hypoglycemia

• 50% DNS infusion ⇒ ⇑ insulin secretion ⇒ hypoglycemia
• Octerocide can prevent Sulfanyl-ureas induced hypoglycemia refer Tintinally for dosage
• Glycogen 1mg SC/IM raise 100mg/dl of glucose in 7-10mins
• Slower than IV Dextrose response