Hypoglycemia is the general term for any pathology involving clinical signs and laboratory signs of lack of glucose (and the transferor resurge, but that we will know after).
Circumstances occurred:
- DT1: Poor adherence, poor understanding (insulin to accommodate the pre prandial blood sugar, with meals provided, if sport after) skip a meal, insulin if taken too early basal bolus doses maladaptive if an intercurrent disease (infection, stress ...)
- DT2: sulfa, poor compliance
Acute-Alcoholization
- Pancreatic Damage: chronic pancreatitis, pancreatic cancer ...
- Another endocrine disorder: Insulinoma, adrenal insufficiency, congenital adrenal hypertrophy, Block 21 hydroxylase enzyme, Cushing disease, acromegaly
- Hepatic insufficiency
- Iatrogenic: Quinine, B, hidden Taking insulin / sulfonylurea
- Genetics: Tuner, T21
- And especially IDIOPATHIC + + + or under nutrition
- Another stuff probably
Adrenergic sweat, tachycardia, palpitation, tremor, heat. Not present if Bbloquants, Hypo repeatedly, Taking insulin for a long time, autonomic neuropathy in diabetics.
Neuro leukopenia: Hunger and painful stomach cramps, paraesthesia, cold, confusion, diplopia, epileptic fit, max coma
Hypoglycemic coma: coma without localizing sign restless, sweating + + +, pyramidal signs (bilateral Babinski, or at least I know more)
Biological signs
Glucose-venous (not capillary) <0.50 g / l (I know in mM) in the nondiabetic, <0.60 g / l in diabetic. What to do If adrenergic signs: fast + slow sugar, make the person sit + / - feet up, ECG differential diagnosis. If signs neurogly copenic: IM glucagon injection or IVD 2ampoules G30%. Emergency hospitalization. Release of the upper airway, recovery position, scope, constants, two large bore intravenous lines. Dosing insulin + C peptide (a marker of endogenous insulin synthesis, helps flush out cheaters which take insulin small hidden - psychiatrist and hospital staff whose IDE + +)
Stopping all hypoglycemic drugs, whether oral anti diabetic stop and put on insulin.
Infusion G10%
Glucose monitoring every four hours + constants
If coma, but ditto sheave emergency hospitalization + / - measures to bedridden (preventing bedsores ...)
Diagnosis after treatment:
Diabetes = plasma glucose (not hair)> 1.26 g / l fasting on two samples at two different times, practice or> 2 g / l at any time day.
HBAIC monitoring (target <7%)
OGTT for etiological confirmation: functional or organic hypoglycemia (insulinoma + +)
I pass on all supported complications of diabetes.
Prevention: If the patient is diabetic.
Reversal of diabetes education:
-Measure's lifestyle modifications + + +: Sport 3x30/sem, balanced diet 5fruits vegetables / day, 50% carbohydrate, 30% lipid (1/3saturée, 1/3polyinsaturée, 1/3monoinsaturée) 20% protein, avoid erosion, three meals / day, avoid food's high glycemic index (soda. .) taken alone, avoiding alcohol (if + + + + metformin).
CAUTION: DO NOT ALLOW FOR FOOD! Everything is permitted but in moderation.
- Observance: Do not stop treatment, do not self medicate)
- Injection techniques: deep SC, change of the site to avoid lipodystrophy ...
- Information: about emergency situations, know the risk behavior, recognize the signs, note in his notebook the dextro and injections, tell the family measures glucagon injections if needed ...
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