Hypoglycemia

[Akulahawk]

Yeah, that acetone odor can smell a LOT like an alcoholic beverage. That odor and the patient not acting right (like they're drunk) can make you think all you've got on your hands is another HBD patient.

HHNK patients still have some insulin that works... enough to keep the body from producing ketones (and therefore the odor). They do NOT have enough insulin to be able to keep the blood glucose levels under control.

 

[Jeffrey_169]

Hypoglycemia does not always equate to diabetes. There are a variety of other causes for both hypo and hyperglycemia.

 

[MrBrown]

Hypoglycemia does not always equate to diabetes.

While you can technically be hypo and non diabetic, I bet you $100 you'd be hard pressed to find a non diabetic hypo of clinical significance

I mean we all feel a bit wonky after missing a meal but I don't count that as being clinically significant

 

[Aidey]

People with Eating Disorders come to mind.

 

[18G]

Hypoglycemia outside of diabetes is pretty rare.

 

[NJFLGHTMDC]

HypoGlycemia without Diabetes

Just don't eat for several days, and you will be come hypoglycemic. Sometimes you will find the syncope in the gym, hypoglycemic. From using up their glycogen stores, and not replacing the energy they processed.
Also it is common to use up your glycogen stores and become hypoglycemic in trauma patients. Think of the excess energy patients use in the different compensatory systems used to keep them alive. We check for hypoglycemia in all trauma patients.
Ill take my $100.

 

[reaper]

How about your chronic alcoholic????

 

[Shishkabob]

Now that's fun one. A drunk with Wernicke-Korsakoff.

 

[reaper]

Other causes,

ASA overdose
Sulfa drugs
Quinine
Alcohol (large amounts in anyone)
Sepsis
Tumors
Hormone deficiencies
kidney problems
Liver problems

There are a lot of causes outside of Diabetes.

 

[18G]

There are causes of hypoglycemia outside of diabetes, agreed. But they are considered infrequent and rare. If you want sources to support this statement I can provide them for you.

How often do you treat a hypoglycemia that isn't related to diabetes?

 

[MrBrown]

Saw an interesting lecture by one of our Clinical Support Officers on glucagon and certian types of diabetics. Cadavet was to call Intermediate or Intensive Care (ALS) for 10% glucose IV rather than sit around for twenty minutes and wait for the IM Glucagon to work because it is unlikely to work.

Specifically mentioned were chronic alcoholics who have seizures and fall down a lot and young, exercise induced hypos in IDDMs

 

[18G]

Chronic alcoholics have a very poor nutritional status and as such have very minimal to no glycogen stores. Throw on top of that the cirrhosis and/or other liver dysfunction caused by the alcohol and the body has an even harder time of maintaining glucose level.

Since alcohol is perceived by the body as a poison, it causes the liver to NOT release any glycogen until all of the alcohol has been metabolized. This is why known diabetics need to eat and have food available in their stomachs if they are going to be consuming alcohol. Because their liver is not going to release glycogen as along as alcohol is present.

 

[reaper]

There are causes of hypoglycemia outside of diabetes, agreed. But they are considered infrequent and rare. If you want sources to support this statement I can provide them for you.

How often do you treat a hypoglycemia that isn't related to diabetes?

I have seen the sources and don't hold much account to them.

You do not treat Sepsis Pt's? Trauma Pt's? Or medication induced Hypoglycemia? You must not treat very many Pt's.