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Hypoglycemia, Nondiabetic

Matthew A. Silva, BCPS, RPh, PharmD and Pablo I Hernandez Itriago, FAAFP, MHCM, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Hypoglycemia is defined by the Whipple triad—low plasma glucose level (≤60 mg/dL) with hypoglycemic symptoms that are relieved when glucose is corrected

  • Occurs commonly in patients wi...

DIAGNOSIS

HISTORY

  • Adrenergic symptoms are prominent with acute drop in glucose ≤60 mg/dL

    • Anxiety, tremulousness, dizziness

    • Diaphoresis, flushing

    • Heart palpitations

    • Adrenergic symptoms may be masked by beta...

TREATMENT

GENERAL MEASURES

  • Oral carbohydrate for alert patient without drug overdose (2 to 3 tbsp of sugar in glass of water or fruit juice, 1 to 2 cups of milk, piece of fruit, or several soda cracker...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Hypoglycemia from sulfonylureas can last for hours to days depending on half-life and renal function. 

DIET

  • High protein, high fiber, complex carb...

REFERENCES

1
Mannucci E, Monami M, Mannucci M, et al. Incidence and prognostic significance of hypoglycemia in hospitalized non-diabetic elderly patients. Aging Clin Exp Res. 2006;18(5):446–451. 
2
Leibo...

SEE ALSO

  • Hypoglycemia, Diabetic; Insulinoma

  • Algorithm: Hypoglycemia

CODES

ICD10

  • E16.2 Hypoglycemia, unspecified

  • E16.1 Other hypoglycemia

  • P70.4 Other neonatal hypoglycemia

  • E16.0 Drug-induced hypoglycemia without coma

SNOMED

  • 302866003 Hypoglycemia (disorder)

  • 197483008 Post gas...

CLINICAL PEARLS

  • Symptoms coincide with low blood glucose levels and resolve with PO/IV glucose or glucagon.

  • Avoid known agents/nutrients that trigger hypoglycemia.

  • Treat underlying cause.

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