II. Signs and Symptoms

  1. Coma
  2. Decreased Appetite
  3. Dizziness
  4. Hypoglycemia
  5. Lethargy
  6. Seizures
  7. Weakness

III. Management: Adults

  1. Dextrose bolus followed by continuous infusion (dose based on degree of Hypoglycemia)
  2. Octreotide (Sandostatin) 50-100 mcg/dose SQ twice to three times daily
  3. Glucagon 1 mg per dose and may repeat every 20 minutes
    1. Only transient elevation in Glucose to temporize until definitive other management

IV. Management: Children

  1. Dextrose bolus followed by continuous infusion
    1. Age 1 to 24 months: Dextrose 25% IV 2-4 ml/kg
    2. Age >24 months: Dextrose 50% IV 1-2 ml/kg
  2. Octreotide (Sandostatin) 4-5 mcg/kg/day SQ divided every 6 hours to maximum of 50 mcg/dose
  3. Glucagon
    1. Infants: 0.025 mg/kg/dose every 20 minutes
    2. Children: 0.5 mg/dose every 20 minutes
    3. Only transient elevation in Glucose to temporize until definitive other management

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