emDocs - November 3, 2016 - Authors: Simon E and Sessions D
Edited by: Santistevan J and Koyfman A
"Key Pearls
- Hypoglycemia may present as alteration in mental status – quickly check a point of care glucose.
- Treat the patient: D50 vs. D10
- D10 may be more appropriate for the critically ill patient
- Do a thorough H&P and obtain a BMP for hypoglycemic diabetic patients:
- Evaluate for medication issues, decreased renal function, missed meals, etc.
- Non-diabetics meeting Whipple’s triad or presenting with a blood glucose ≤ 40mg/dL = need a thorough H&P to dictate evaluation and treatment
- Critically ill (sepsis, CKD, etc) + hypoglycemic = Admit
- Well + hypoglycemic = Ok for discharge and specialist follow-up if no concern for recurrent hypoglycemia (sulfonylurea ingestions, etc.)
- Insulin pump = unlikely to be the etiology of the patient’s hypoglycemia
- If suspected pump malfunction => turn off the pump and remove the subcutaneous attachment; manage the patients glucose parenterally
- Call the device representative"