Hypoglycemia symptoms

Case (ii) A 25-year-old female patient with idiopathic spontaneous hypoglycemia. Symptoms recurrent hypoglycemic shock, blood sugar 18-20 mg/lOOml during the episode, hot patient, excessive craving for sweets, short necked, fanciful dreams. Earlier she had recurrent tonsilitis and skin disease treated by antibiotics. 

Glucose is also called blood sugar. It is absorbed readily into the bloodstream and is normally found there at concentrations ranging from 0.004 to 0.008 mol/L. If the concentration of glucose drops below 0.003 M, a condition called hypoglycemia is created, with symptoms ranging from nervousness to loss of consciousness. If the glucose level rises above 0.01 M, as can easily happen with diabetics, it is excreted in the urine. 

SYMPTOMS HYPOGLYCEMIA (INSUUN REACTION) HYPERGLYCEMIA (DIABETIC COM A, KETOACIDOSIS)... 

The nurse notifies the health care provider of any hypoglycemic reaction, die substance and amount used to terminate the reaction, blood samples drawn (if any), the length of time required for die symptoms of hypoglycemia to disappear, and die current status of the patient. After termination of a hypoglycemic reaction, the nurse closely observes die patient for additional hypoglycemic reactions. The lengtii of time close observation is required depends on die peak and duration of the insulin administered. 

Know the symptoms of hypoglycemia and hyperglycemia and the health care provider s method for terminating a hypoglycemic reaction. 

Camitine deficiency can occur particularly in the newborn—and especially in preterm infants—owing to inadequate biosynthesis or renal leakage. Losses can also occur in hemodialysis. This suggests a vitamin-fike dietary requirement for carnitine in some individuals. Symptoms of deficiency include hypoglycemia, which is a consequence of impaired fatty acid oxidation and hpid accumulation with muscular weakness. Treatment is by oral supplementation with carnitine. 

Monitor for adverse effects of 3-blockers—heart rate, blood pressure, fatigue, masking of symptoms of hypoglycemia and/or glucose intolerance (in patients with diabetes), wheezing or shortness of breath (in patients with asthma or chronic obstructive pulmonary disease), etc. 

The answer is d, (Hardman, pp 855-856.) Propranolol, as well as other non selective beta blockers, tends to slow the rate of recovery in a hypoglycemic attack caused by insulin. Beta blockers also mask the symptoms of hypoglycemia and may actually cause hypertension because of the increased plasma epinephrine in the presence of a vascular beta2 blockade. 

The initial neurological symptoms of hypoxia and hypoglycemia result from reduced synthesis of neurotransmitters rather than a global cerebral energy deficit 594... 

In liver phosphorylase deficiency (glycogenosis type VI, Hers disease Fig. 42-1) and in two genetic forms of phosphorylase kinase deficiency, one of which is X-linked recessive, the other of which is autosomal recessive, hypoglycemia is either absent or mild. Symptoms of brain dysfunction do not usually occur (type VIII, Fig. 42-1) [1],... 

Fatty acid oxidation defects often produce recurrent disturbances of brain function [4, 8]. Drowsiness, stupor and coma occur during acute metabolic crises and mimic the Reye s syndrome phenotype. The neurological symptoms have been attributed to hypoglycemia, hypoke-tonemia and the deleterious effects of potentially toxic... 

Disopyramide Anticholinergic symptoms (dry mouth, urinary retention, constipation, blurred vision), nausea, anorexia, TdP, HF, aggravation of underlying conduction disturbances and/or ventricular arrhylhmias, hypoglycemia... 

Deficiency of hepatic glucose 6-phosphatase produces a profound fasting hypoglycemia, lactic acidosis, and hepatomegaly. Additional symptoms include ... 

The side effects of beta blockers include decreased blood pressure, dizziness, and sedation. They are also believed by some to worsen symptoms of depression in vulnerable individuals, though how beta blockers such as atenolol that do not enter the brain might do so is not readily understandable. In addition, beta blockers should be avoided in diabetic patients because they may dangerously mask the symptoms of hypoglycemia. Finally, beta blockers should not be taken by patients with emphysema (COPD) or asthma. 

The most common adverse events leading to discontinuation during trials were hyperglycemia, hypoglycemia, and related symptoms. 

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