What is acute hypoglycemia?

Updated: Dec 16, 2016
  • Author: Frank C Smeeks, III, MD; Chief Editor: Erik D Schraga, MD  more...
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Answer

Answer

Treatment and disposition of hypoglycemia are guided by the history and the clinical picture. Serum glucose should be measured frequently and used to guide treatment, because clinical appearance alone may not reflect the seriousness of the situation.

Hypoglycemia is defined according to the following serum glucose levels:

  • < 50 mg/dL in men

  • < 45 mg/dL in women

  • < 40 mg/dL in infants and children

If the cause of hypoglycemia is other than oral hypoglycemic agents or insulin in a diabetic patient, other lab tests may be necessary.

In a cross-sectional study of 291 adults presenting to the emergency department (ED) with hypoglycemia (≤ 60 mg/dL) or altered mental status resolved by glucagon or glucose, Sinert et al determined that routine laboratory testing is justified in patients presenting to the ED with hypoglycemia because of the high rate of abnormal laboratory results. [1] Of the 291, 200 (69%) had at least 1 laboratory abnormality, including newly diagnosed (23%) or preexisting (32%) renal failure, hypokalemia (8%), hyperkalemia (11%), leucocytosis (4.2%) and pyuria (19%).

A retrospective study by Lipska et al on trends in US hospital admissions for hyperglycemia and hypoglycemia from 1999 to 2011 that included 279,937 patients found that the rates of admissions for hyperglycemia decreased from 114 to 70 admissions per 100,000 while admissions for hypoglycemia increased from 94 to 105 admissions per 100,000. Hypoglycemia rates were also 2-times higher for patients 85 years of age or older and admission rates for both hyperglycemia and hypoglycemia were 4 times higher for black patients. [2]


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