Treatments for Hypoglycemic attack
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Hospital statistics for Hypoglycemic attack:
These medical statistics relate to hospitals, hospitalization and Hypoglycemic attack:
- 0.0005% (62) of hospital consultant episodes were for nondiabetic hypoglycaemic coma in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 69% of hospital consultant episodes for nondiabetic hypoglycaemic coma required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 45% of hospital consultant episodes for nondiabetic hypoglycaemic coma were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 55% of hospital consultant episodes for nondiabetic hypoglycaemic coma were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
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Book Excerpts: Treatment of Hypoglycemic attack
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Hypoglycemia:
Treatment
(In a Page: Signs and Symptoms)
-
Glucose therapy (therapy goal is glucose >100 mg/dL)
–Alert patients may be repleted with oral glucose (e.g., juice, glucose tablets) or IV D50
–Patients with altered consciousness require IV D50 solution
–In children, use bolus of 25% dextrose
–Frequently recheck blood glucose
Glucagon may be used to increase glucose release from the liver if unable to obtain IV access and the patient cannot tolerate oral glucose; less effective in alcoholic and malnourished patients
Octreotide may be used in cases of sulfonylurea-induced hypoglycemia to inhibit insulin release
Thiamine must be given with glucose in any suspected case of alcohol abuse or nutritional deficiency to avoid Wernicke's encephalopathy
Hydrocortisone should be administered if blood glucose remains persistently low to rule out adrenal insufficiency
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Hypoglycemia:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
If awake and alert, give glucose/feed orally
-
If impaired consciousness, D10 or D25 2-4 cc/kg IV/NG
-
For hyperinsulinism:
–Glucagon injection acutely
–Supranormal glucose intake chronically
–Dietary manipulation (increased feeding frequency, some are protein sensitive)
–Medical options: Diazoxide, octreotide
–Surgical option: Subtotal pancreatectomy
-
For defects in fasting adaptation (including defects in glycogenolysis, gluconeogenesis, fatty acid oxidation, and ketogenesis): Frequent or continuous feeding, night-time cornstarch helpful for some
-
For hormone deficiencies: Hormone replacement (i.e., growth hormone and/or hydrocortisone)
-
Goals of therapy: Prevent recurrent hypoglycemia, prevent catabolic state, promote growth and development
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Hypoglycemia:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Effective treatment of reactive hypoglycemia requires dietary modification to help delay glucose absorption and gastric emptying. Usually this includes small, frequent meals; ingestion of complex carbohydrates, fiber, and fat; and avoidance of simple sugars, alcohol, and fruit drinks. The patient may also receive anticholinergic drugs to slow gastric emptying and intestinal motility and to inhibit vagal stimulation of insulin release.
For fasting hypoglycemia, surgery and drug therapy are usually required. In patients with insulinoma, tumor removal is the treatment of choice. Drug therapy may include nondiuretic thiazides such as diazoxide to inhibit insulin secretion; streptozocin; and hormones, such as glucocorticoids and long-acting glycogen.
Therapy for neonates who have hypoglycemia or who are at risk of developing it includes preventive measures. A hypertonic solution of 10% dextrose, calculated at 5 to 10 ml/kg of body weight administered I.V. over 10 minutes and followed by 4 to 8 mg/kg/minute for maintenance, should correct a severe hypoglycemic state in neonates. To reduce the chance of hypoglycemia in high-risk neonates, they should receive feedings (either breast milk or a solution of 5% to 10% glucose and water) as soon after birth as possible.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Hypoglycemia:
Treatment
(Handbook of Diseases)
Urgent treatment may be provided by glucose tablets, candy, or fluids if the patient is alert. Dextrose 50% solution is given for emergency treatment, followed by a constant infusion in children and adults. Reactive hypoglycemia and fasting hypoglycemia require different treatments.
Reactive hypoglycemia
Effective treatment of reactive hypoglycemia requires dietary modification to help delay glucose absorption and gastric emptying. Usually, this includes small, frequent meals; ingestion of complex carbohydrates, fiber, and fat; and avoidance of simple sugars, alcohol, and fruit drinks.
The patient may also receive anticholinergic drugs to slow gastric emptying and intestinal motility and to inhibit vagal stimulation of insulin release.
Fasting hypoglycemia
In fasting hypoglycemia, surgery and drug therapy are usually required. In patients with insulinoma, removal of the tumor is the treatment of choice. Drug therapy may include nondiuretic thiazides, such as diazoxide, to inhibit insulin secretion, streptozocin, and hormones, such as glucocorticoids and long-acting glycogen.
In neonates
Therapy for neonates who have hypoglycemia or who are at risk of developing it includes preventive measures. A hypertonic solution of dextrose 10%, calculated at 5 to 10 ml/kg of body weight administered I.V. over 10 minutes and followed by 4 to 8 mg/kg/minute for maintenance, should correct a severe hypoglycemic state in neonates.
To reduce the chance of hypoglycemia in high-risk neonates, they should receive feedings — either breast milk or a solution of dextrose 5% or 10% in water — as soon after birth as possible.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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