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Hypoglycemia, low blood glucose
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- Common: jitteriness, irritability,
pallor
- Sweating, weakness
- Headache, hunger, clouding of consciousness, convulsions
- Also, there may be no symptoms
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- Most body hormones raise blood glucose; insulin lowers blood glucose. Therefore, when insulin is present in blood at greater than normal levels, Hypoglycemia can occur; and similarly, when other body hormones are decreased.
- Poisonings (aspirin)
- Inborn Errors of metabolism
- Liver or pancreatic disease
- Starvation or prolonged fasting
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- An abnormally low blood glucose establishes hypoglycemia
if treatment with glucose rapidly corrects both the blood
glucose level, and any symptoms. It is necessary, beyond this
diagnosis, to perform history, physical, and other laboratory
tests to find the underlying cause (for example, Inborn Errors of metabolism).
- Blood glucose is measured either by obtaining capillary
blood by finger-stick/heelstick, or by obtaining venous
blood.
- Laboratory error may give a falsely low blood glucose.
- Taking a capillary blood sample from a finger that is
cold, or a heel that is cold, can give a falsely-low blood
sugar. Taking a blood sample from blood that has
accidentally-clotted, can give a falsely-low blood
sugar.
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- In the fetus of a diabetic mother: if
the mother's blood glucose is high, mother's glucose
crosses the placenta into the fetus and stimulates the fetal
pancreas to make more insulin. At birth, the separation of the
infant from the placenta makes the infant of a diabetic
mother have the potential for a high insulin level
to cause hypoglycemia.
- Low birth weight infants
- See causes
- Generally, there are 2 age groups at risk: the first 6
months of life, and the two to four year age group. The first
3 days of life are a risk factor for the infant of a diabetic
mother; premature infants; and low birth weight infants who
are not premature.
- Diabetic pediatric patients on insulin are at risk for
hypoglycemia, at any age. This also applies to adults who were
juvenile diabetics.
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- Rapid correction of acute hypoglycemia(newly-happening
hypoglycemia) is usually done by administering glucose
intravenously (IV). Sometimes, continued IV glucose is
needed, depending on serial blood glucose measurements.
- Glucagon (a hormone that promotes release of stored sugar
from the liver) is sometimes used, when I.V. glucose or a
suitable vein for IV fluids is not available.
- In some instances, with stable patients, hypoglycemia is
treated with oral feedings or with a nasogastric tube
feeding.
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- Seizures, coma, brain damage, mental retardation
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- A prompt measurement of blood glucose, and treatment by a physician, are both essential.
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- Infants withdrawing from maternal street drugs
- Diseases of the central nervous system
- Diseases with clouding of consciousness
- Electrolyte imbalance
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