What is the management of acute hypoglycemia?

Whether acute or chronic hypoglycemia, especially recurrent hypoglycemia, suggests the presence of some kind of disease, and the cause should be identified as early as possible, which is the key to treatment. In order to avoid serious consequences, the following treatments are preformed.

(1) Glucose application. For acute and severe hypoglycemia with coma, in order to avoid progressive changes in the condition, 50% glucose solution must be injected intravenously 50 ~ 100 ml, repeated 1 ~ 2 times if necessary, until the patient is conscious, followed by 10% glucose solution intravenously, so that the blood glucose is maintained at 8.3 ~ 11.1 mmol/L, and observed for 12 ~ 48 hours, in order to facilitate the recovery of the brain cells and to prevent the resumption of coma. If you do not have the above conditions, the hypoglycemic coma, and should not drink sugar water caused by asphyxiation, this time, we can use honey or jam, etc. coated in the patient's teeth, oral mucosa, or nasal sugar water is also one of the first aid measures.

(2) Glucagon application. Can be applied after the onset and 50% glucose solution at the same time, the general dose of 0.5 ~ 1.0mg, can be subcutaneous or intramuscular injection, most of the 10 ~ 30 minutes after the recovery of consciousness, if necessary, repeat the application.

(3) Adrenaline application. When severe hypoglycemia with shock, and do not have the above conditions, can be applied in small and medium doses, but hypertensive patients and the elderly should be used with caution.

(4) Mannitol application. After the above treatment, blood sugar has been restored, but still coma time more than 30 minutes of patients, for hypoglycemic coma may be accompanied by cerebral edema, can be considered for intravenous infusion of 20% mannitol 40g, within 20 minutes of the end of the infusion.

(5) Adrenocorticotropic hormone application. After high glucose treatment, although the blood glucose has been maintained 8.3 ~ 11.1mmol / L, but has reached 15 ~ 30 minutes of consciousness is still not awake, in order to make the brain is not damaged, can be applied to adrenocorticotropic hormone 100 ~ 200mg (or dexamethasone 10mg) as appropriate, 4 ~ 8 hours once, **** 2 ~ 3 times.