Hypoglycemia: Essential Clinical Guidelines

Abstract

Hypoglycemia is the acute complication of diabetes mellitus and the commonest diabetic emergency and is associated with considerable morbidity and mortality. It can be caused by too much insulin intake or oral hypoglycemic agents, too little food, or excessive physical activity. The level of glucose that produces symptoms of hypoglycemia varies from person to person and varies for the same person under different circumstances. It characterized by sweating, tremor, tachycardia, palpitation, nervousness, hunger, confusion, slurred speech, emotional changes, double vision, drowsiness, sleeplessness, and often self-diagnosed which may leads to serious symptoms of seizure, cognitive impairment, coma and death. The immediate treatment of hypoglycemia should be known by all the diabetic patients, so that need for hospitalization could be avoided. Hypoglycemia and its severity can be prevented by early recognition of hypoglycemia risk factors, self-monitoring of blood glucose, selection of appropriate treatment regimens, appropriate educational programs for healthcare professionals. The major challenges of the treatment of hypoglycemia are good glycemic control, minimize the risk of hypoglycemia and thereby minimize long-term complications. Hence there is an urgent need to understand the clinical spectrum and burden of hypoglycemia so that adequate control measures can be implemented against this life-threatening complication.

The Level of Knowledge About Risk Factor for Hypoglycemia Among Diabetes Mellitus Patient in Primary Health Center Tegallalang I Region, Bali Province

“…14 Sebuah studi melaporkan bahwa sekitar 90% pasien yang menerima terapi insulin memiliki pengalaman mengalami hipoglikemia. 15 Asupan nutrisi sangat penting untuk mengontrol kadar glukosa darah pasien diabetes melitus. 16 Namun pasien diabetes melitus cenderung tidak memperhatikan asupan nutrisi dan keteraturan waktu makan.…”

Hypoglycaemia Among Diabetes Patients: A Preventive Approach

“…But most patients do not receive the regular ongoing screening, education, and training support to prevent and self-manage hypoglycaemia when it occurs (Shubrook, 2020). Thenmozhi Paluchamy has emphasized on causes and risk factors, recognition of symptoms, glucose regulatory and counter regulatory mechanism, management and prevention strategies of hypoglycaemia (Paluchamy, 2019).…”

“…In Level I hypoglycaemia, the range of blood glucose level is 54-70mg/dl (3-3.9mmol/l). The symptoms at this level are tremor, palpitations, tachycardia, nervousness, sweating and hunger due to sympathetic nervous system is stimulation (Gehlaut & Shubrook, 2014;Paluchamy, 2019). In Level II hypoglycaemia, the range of blood glucose level is 40-54mg/dl (2.2-3mmol/l).…”

“…In Level II hypoglycaemia, the range of blood glucose level is 40-54mg/dl (2.2-3mmol/l). The symptoms at this level are irritation, inability to concentrate, headache, lightheadedness, memory loss, confusion, numbness of the lips and tongue, slurred speech, lack of coordination, emotional changes, drowsiness, and double vision, or any combination of these symptoms due to impaired function of central nervous system (Paluchamy, 2019;ADA, 2020b). In Level III hypoglycaemia, the blood glucose level is less than 40mg/dl (2.2mmol/l) (Pettus et al, 2019).…”

Hipoglikemia Pada Pasien Diabetes Melitus

“…Menurut Yale et al [5] dan Paluchamy [10], tingkat keparahan hipoglikemia pada pasien DM dikategorikan sebagai berikut : Tabel 2. Tingkat keparahan hipoglikemia…”