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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com


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jueves, 3 de noviembre de 2016

Hypoglycemic Patient

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"