Critical Care Medicine
1. Description of the problem
What every clinician needs to know
Hypoglycemia may be associated with mortality and neurologic complications such as seizures and coma.
It is uncertain what the clinical consequences from hypoglycemia are in ICU patients.
In diabetes patients, hypoglycemia is associated with:
Diverse symptoms such as anxiety, palpitations, tremor, sweating, hunger and paresthesias.
Neurologic symptoms such as behavioral changes, cognitive dysfunction, seizures and coma.
Key management points
Stop insulin infusion.
Check blood glucose within 30-60 minutes.
2. Emergency Management
Emergency management steps
Stop insulin infusion (and oral antidiabetic agents).
Administer 10 to 20 mL Glucose 50% intravenously.
Check blood glucose concentration within 30 to 60 minutes.
Drugs and dosages
Establishing a specific diagnosis
Different cutoffs have been used in literature to define hypoglycemia in ICU patients. These range from lower than 81 mg/dL to lower than 40 mg/dL. Generally, blood glucose concentration below 60 mg/dL is considered to be hypoglycemia.
Normal lab values
Normal blood glucose: 80-110 mg/dL
Glucose is the obligate fuel for the brain. Glucose cannot be synthesized by the brain, and glycogen storage supplies last for only minutes. Low blood glucose will therefore result in brain damage.
Tight blood glucose control in ICU patients is associated with an increased incidence of hypoglycemia and also with increased mortality, and may occur in up to 28% of patients.
What's the evidence?
Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.
No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.
Regimen and Drug Listings
GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION
|Head and Neck Cancer||Regimens||Drugs|
|Renal Cell Carcinoma||Regimens||Drugs|
Cancer Therapy Advisor Articles
- Long-term Survival From Ipilimumab/Nivolumab Combination in Metastatic Melanoma
- Questions Remain for First-line Treatment Selection and Sequencing in Advanced Melanoma
- Repeat T790M Testing Recommended for TKI-resistant Patients With NSCLC
- Ginkgo Biloba and Cancer
- Initial Therapy at Academic Centers Linked to Prolonged Overall Survival in NSCLC
- Affordable Care Act Linked to Lower Rates of Cancer Diagnosis Among Uninsured
- FDA Approves Axicabtagene Ciloleucel for Non-Hodgkin Lymphoma, Questions Remain About Cost and Toxicity
- PAK Inhibition Could Abrogate MAPK Inhibitor Resistance in BRAF-mutant Melanoma
- Lung Cancer Treatment in North America: Recent Advances and Future Promises
- Atezolizumab Maintains Clinical Benefit After 2 Years in Advanced NSCLC