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Home | Articles | Diabetes and Endocrinology | Hypoglycaemia

Hypoglycaemia

Last updated 3rd December 2020

Last Updated on 4th June 2013 by Calum Murray

A diabetic emergency. Defined as BG <4mmol/l. If not <4mmol/l but symptomatic give small carbohydrate snack for symptom relief.

 

 

 

Notes

  1. DO NOT omit next dose of insulin, though dose reduction insulin/OHA may be necessary. Let patient know if dose changed.
  2. Rebound hyperglycaemia will occur – do not treat.
  3. Avoid 50% glucose if possible – can cause tissue necrosis if extravasates
  4. Glucagon may take up to 15 mins to work and may be ineffective in patients with severe liver disease or who are undernourished
  5. Glucagon should not be used when oral hypoglycaemic agents have caused hypoglycaemia
  6. Long acting sulphonylureas may cause prolonged hypoglycaemia and require monitoring with dextrose infusion for 24 hrs or more

Consider Causes of Hypoglycaemia 

  1. Inadequate food intake, fasting,miseed meals
  2. Too much insulin/sulphonylurea
  3. Insulin/drug administration at wrong time
  4. Problems with insulin injection site – check for signs of lipohypertrophy
  5. Increased physical activity
  6. Sudden discontinuation steroids/associated hypoadrenalism
  7. Renal or hepatic impairment
  8. Alcohol excess
  9. Pancreatic disease

Following a Hypo

  1. Continue regular capillary BG monitoring for 24-48 hours, give hypoglycaemia education and refer Diabetes Specialist Nurse for advice.

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