Endocrinology Book

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Hypoglycemia

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  1. Causes
    1. Diabetes Mellitus on Insulin or Insulin Secretagogue
    2. Postprandial Hypoglycemia (Reactive Hypoglycemia)
    3. Fasting Hypoglycemia
  2. Symptoms
    1. Sympathetic response
      1. Sweating
      2. Tremor
      3. Tachycardia
      4. Anxiety
      5. Hunger
    2. CNS symptoms
      1. Dizziness
      2. Visual disturbance
      3. Confusion
      4. Convulsions
      5. Syncope
  3. Diagnosis: Whipple's Triad
    1. Low Plasma Glucose
      1. Men < 2.8 mmol/L (50 mg/dl)
      2. Women < 2.2 mmol/L (40 mg/dl)
    2. Hypoglycemic Symptoms
      1. May be masked by certain conditions or medications
        1. Autonomic Neuropathy
        2. Beta Blockers
    3. Symptoms improve with plasma glucose correction
  4. Management
    1. See Hypoglycemia Management
  5. General Dietary Measures
    1. Avoid fasting
    2. Small, frequent meals

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