hypoglycaemia

What is hypoglycaemia?

A blood glucose level that is too low; in most people with diabetes, usually below 4.0 mmol/L.

Why is hypoglycaemia dangerous?

The brain depends heavily on glucose, so low blood glucose can impair brain function and progress to seizure or unconsciousness.

What are the two main symptom groups in hypoglycaemia?

Autonomic symptoms and neuroglycopenic symptoms.

What causes autonomic symptoms in hypoglycaemia?

The body detects falling blood glucose and activates stress hormone/autonomic responses.

Why does hypoglycaemia cause shaking or tremor?

Adrenaline activates the sympathetic nervous system, causing tremor.

Why does hypoglycaemia cause sweating?

Autonomic nervous system activation, especially cholinergic activity, causes sweating.

Why does hypoglycaemia cause palpitations?

Adrenaline increases heart activity, causing a fast or pounding heartbeat.

Why does hypoglycaemia cause hunger?

The body is signalling the need for carbohydrate/glucose intake.

Why can hypoglycaemia cause anxiety or irritability?

Stress hormone release and brain glucose shortage can affect mood and behaviour.

What are neuroglycopenic symptoms?

Symptoms caused by inadequate glucose supply to the brain.

Why does hypoglycaemia cause confusion?

The brain is not receiving enough glucose to function normally.

Why can hypoglycaemia cause slurred speech?

Brain glucose deprivation impairs normal neurological function.

Why can hypoglycaemia cause drowsiness?

Reduced glucose supply to the brain lowers alertness and consciousness.

Why can severe hypoglycaemia cause seizure or unconsciousness?

Severe brain glucose deprivation can disrupt normal brain electrical activity and consciousness.

What are early signs of hypoglycaemia?

Sweating, shaking, hunger, palpitations, dizziness, headache, anxiety, irritability.

What are late or severe signs of hypoglycaemia?

Confusion, slurred speech, drowsiness, seizure, unconsciousness.

What should you suspect if a diabetic patient is sweaty, shaky, pale, and confused?

Hypoglycaemia until proven otherwise.

What is the first assessment for suspected hypoglycaemia?

Check blood glucose level and assess conscious state.

Why should you assess conscious state before giving oral glucose?

If the patient cannot swallow safely, oral intake can cause choking or aspiration.

What should you not do if a patient is unconscious or unable to swallow?

Do not give food, drink, or oral glucose by mouth.

Why can insulin cause hypoglycaemia?

Insulin lowers blood glucose by moving glucose from the blood into cells; too much insulin effect can drop blood glucose too low.

Why can missing a meal after insulin cause hypoglycaemia?

Insulin continues lowering blood glucose, but not enough carbohydrate is absorbed from food to replace it.

Why can exercise cause hypoglycaemia?

Muscles use more glucose during activity, which can lower blood glucose.

Why can alcohol increase hypoglycaemia risk?

Alcohol can impair the liver’s ability to release glucose, especially if food intake is low.

What history should you ask after a hypoglycaemic episode?

Last meal, last insulin/diabetes medication, exercise, alcohol, vomiting/diarrhoea, illness, previous hypos.

How is hypoglycaemia different from diabetic ketoacidosis?

Hypoglycaemia is low blood glucose; diabetic ketoacidosis is high blood glucose with ketones and acidosis.

How is hypoglycaemia different from hyperosmolar hyperglycaemic state?

Hypoglycaemia is low blood glucose; hyperosmolar hyperglycaemic state is very high blood glucose with severe dehydration.

What is the nursing priority in hypoglycaemia?

Recognise quickly, check blood glucose, assess safety/conscious state, follow protocol, escalate if needed.

What should be documented after hypoglycaemia?

Blood glucose level, symptoms, treatment given, response, repeat blood glucose, likely cause, escalation, and education.

What patient education helps prevent hypoglycaemia?

Eat regular carbohydrates, match insulin/medication with meals, monitor blood glucose, plan for exercise, carry fast-acting glucose, and know hypo symptoms.