Diabetic hypoglycaemia

Diabetes mellitus 

This is a type of hypoglycaemia.
Also known as insulin shock (when severe).

 

History

• Rapid onset

Symptoms

• Headache
• Blurred vision
• Dizziness
• Tachycardia
• Confusion
• Tremors

 

Signs

• Diaphoresis (sweating)
• Pallor
• Low and falling GCS

 

Causes

• Treatment of diabetes mellitus
• Classically insulin overdose 
• Overdose of oral antihyperglycaemic agents

 

Complications

• Seizures
• Diabetic coma

Comparison with diabetic ketoacidosis

• DHG is more common than DKA
• Low blood glucose in DHG
• Faster onset of DHG
• Moist, pale in DHG
• Normal respirations in DHG
• Normal or high blood pressure in DHG
• Seizures common in DHG
• No dehydration in DHG
• Urine output normal in DHG
• Disoriented or comatose in DHG
• Rapid recovery after treatment of DHG

Management

• Glucose IV or PO
• Glucagon IV or IM