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General Medicine

Hypoglycemia, Diabetic

Joseph A. Florence, MD and Emily K. Flores, PharmD, BCPS Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Abnormally low concentration of glucose in circulating blood of a patient with diabetes mellitus (DM); often referred to as an insulin reaction

  • Classification includes the following (...

DIAGNOSIS

HISTORY

  • Discuss quality, quantity, awareness, and causes of hypoglycemia (1)[A].

  • Symptoms vary considerably between individuals.

  • Adrenergic symptoms

    • Hunger, trembling, pallor, sweating, shakin...

TREATMENT

GENERAL MEASURES

  • Glucose: pure glucose preferred; any form of CHO that contains glucose should be effective (see “Medication” section below) (1)[A].

  • Glucagon should be prescribed to patients a...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Rest until glucose is normal. Individuals with poor cognitive function or severe hypoglycemia should have their glycemic therapy tailored to avoid significant hyp...

REFERENCES

1
American Diabetes Association. Standards of medical care in diabetes–2017. Diabetes Care.  2017;40(Suppl 1):S1–S135.
2
Seaquist ER, Anderson J, Childs B, et al. Hypoglycemia and diabete...

ADDITIONAL READING

Thompson AE. JAMA patient page. Hypoglycemia. JAMA.  2015;313(12):1284. [View Abstract on OvidMedline] 

SEE ALSO

  • Diabetes Mellitus, Type 1

  • Algorithm: Hypoglycemia

CODES

ICD10

  • E11.649 Type 2 diabetes mellitus with hypoglycemia without coma

  • E10.649 Type 1 diabetes mellitus with hypoglycemia without coma

  • E13.649 Oth diabetes mellitus with hypoglycemia without coma

ICD9

CLINICAL PEARLS

  • Address hypoglycemia in every visit with patients at risk.

  • Best treatment includes:

    • Patient education and empowerment

    • Frequent SMBG

    • Flexible insulin (or other drug) regimens

    • Regular profe...

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