Hypoglycemia and Electrolyte Abnormality

Causes

Hypoglycemia most common causes sach as includes:

• Prematurity, intrauterine growth retardation, perinatal asphyxia
• Maternal hyperglycemia due to diabetes
• Prolonged fasting
• Congenital hyperinsulinism several types, both transient and persistent
• Inborn errors of carbohydrate metabolism such as glycogen storage disease
• Insulin-induced hypoglycemia
  • Insulin injected for type 1 diabetes
  • Factitious insulin injection
  • Insulin-secreting pancreatic tumor
  • Reactive hypoglycemia and idiopathic postprandial syndrome
• Sepsis
• Living in areas with indigenous B sapida, having low socioeconomic status, and consuming certain ethnic cuisine predispose to exposure.
• Risk factors include ingestion of unripe ackee fruit, canned ackee fruit, or water in which unripe ackee fruit has been cooked.

Symptoms

• Vomiting
• Diarrhea
• Poor feeding

Signs

• Prolonged seizures
• Altered mental status
• Clinical evidence of dehydration or shock
• Hypothermia (rectal temperature < 36.5° C) ++++ in infants with hyponatremic seizures

Treatment

The blood glucose can be raised to normal within minutes by taking 10-20 grams of carbohydrate. This amount of carbohydrate is contained in about 3-4 ounces of orange, apple, or grape juice, about 4-5 ounces of regular about one slice of bread, about 4 crackers, or 1 serving of most starchy foods. Starch is quickly digested to glucose, but adding fat or protein retards digestion. Symptoms should begin to improve within 5 minutes, though full recovery may take 10-20 minutes. Overfeeding does not speed recovery and if the person has diabetes will simply produce hyperglycemia afterwards.

If a person is suffering such severe effects of hypoglycemia that they should not be given anything by mouth, glucose can be given by intravenous infusion or the glucose can be rapidly raised by an injection of glucagon. Further details of glucagon use are provided in the article on diabetic hypoglycemia.