Chapter 26: Hypoglycemia
Harrison’s Manual of Medicine 20th edition provides 600+ internal medicine topics in a rapid-access format. Download Harrison’s App to iPhone, iPad, and Android smartphone and tablet. Explore these free sample topics:
-- The first section of this topic is shown below --
Glucose is an obligate metabolic fuel for the brain. Hypoglycemia should be considered in any pt with confusion, altered level of consciousness, or seizures. Counterregulatory responses to hypoglycemia include insulin suppression and the release of catecholamines, glucagon, growth hormone, and cortisol.
The laboratory diagnosis of hypoglycemia is usually defined as a plasma glucose level <2.5–2.8 mmol/L (<45–50 mg/dL), although the absolute glucose level at which symptoms occur varies among individuals. For this reason, Whipple’s triad should be present: (1) symptoms consistent with hypoglycemia, (2) a low plasma glucose concentration measured by a method capable of accurately measuring low glucose levels (not a glucose monitor), and (3) relief of symptoms after the plasma glucose level is raised.