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Hypoglcyemia


this protocol is ideal for persons who have had a known overdose of sulfonylurea medications



Inclusion Criteria

  • Blood sugar below 40 mg% pre Rx (if obtained) and 80 post treatment
  • Symptoms resolved with administration of glucose
  • Type I or Type II Diabetes
  • Etiology determined (e.g. missed a meal)

Exclusion Criteria

  • Intentional overdosage of hypoglycemic medications
  • Use of long acting oral hypoglycemic agent such as diabeta
  • Insufficient change in symptoms with administration of glucose
  • Fever, hypothermia (T < 35C or T > 38C)
  • D5-D10 drip required to maintain euglycemia

Potential Interventions

  • Dietary food tray
  • Serial exams and vital signs
  • IV hydration, K administration or electrolytes as indicated
  • Serial lab - repeat glucose Q2-4hr and as indicated
  • IV D-50 (or oral juice if alert) for hypoglycemia and confusion – notify physician
  • Diabetic counseling as needed

Discharge Criteria

Home

    • Resolution of symptoms
    • Capable adult supervision
    • Bedside glucose over 80 mg%
    • Resolution of precipitating factor
    • Follow up with primary care

Admit

    • Deterioration of clinical signs
    • Persistent deficits in neurological status
    • Bedside glucose consistently < 80

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