Hipoglycemia | Figure 1

DraMohn

Hipoglycemia

A woman 50 years old, diagnosed with Diabetes mellitus 15 years ago, treated with insulin NPH 5UI in the morning and 15UI in the afternoon, is brought to the unit after presenting diaphoresis, confusion and alteration of the sensory state, reason for the Which her relatives bring. The patient omits feeding some occasions after the application of insulin. EF is sleepy, irritable, destrostix 30mg / dL, presents 120/80 mmHg arterial pressure, 88 heart rate, 22 respiratory rate, cardiopulmonary without aggregates normoperistaltic abdomen, limbs without compromise.

How do you handle this patient?

What tests would you ask for?

What is your presumptive diagnosis?

Do they hospitalize or graduate the patient?

Similar Cases

female patient presented with DKA. Hx of Hepatitis, and drug abuse no DM. I admitted patient in ICU on insulin protocol. Within 2 hours BG was under 200 and she was alert and going through opiate withdrawls.

Female 41 years, diabetes mellitus 14 years of "controlled" evolution with insulin glargine, arterial hypertension without treatment. She goes to the office for lower edema. On examination, this edema is observed +++, scraping footprints in the legs, referring to intense pruritus in the early hours until injury, TA 180 / 100mmHg, 118mg / dL capillary glucose. What is the sign of the edema? How do you treat this patient?

Patient Inquiry

I was at work this evening and had a patient with DM controlled with insulin. Daily they take Lantus 16 units in the morning and then Apidra 7u with meals. This evening their BG was 81 and they refused their apidra, also, prior to being seen by the endocrinologist there were parameters in the apidra - hold of BG less than 90. So that being said I faxed the endocrinologist and asked them if they would like to reinstate the parameters of the apidra, and also made them aware she refused her dinner dose. His response was that she should still get it (yes, but she refused) and then he stated that if her BG is less than 80 to give her 15g of sugar and then give her her apidra dose. Is this common practice to bump up a diabetic just to give them insulin? And if so, why? Her BG at HS was 188 even without the dinner apidra. Just curious why she should be given sugar just to get insulin. Thoughts?