Management of Hypoglycaemia Case 3 Q1-4

A 24-year-old man is brought to the ED by colleagues who found him collapsed at his desk at work.

On arrival he is drowsy but rousable and agitated on assessment.

His GCS is 13 (E3, V4, M6).

His pulse is 100 and CBG 1.9 but he will not allow other observations to be taken.

Which of the following is the most appropriate initial treatment for him?

After 20 min repeat CBG is 3.0. He is more cooperative. What treatment is appropriate now?

After the second treatment he makes a full recovery and is keen to go home. What criteria will you use for safe discharge?

List three or more criteria.

Although different in each patient, symptoms of hypoglycaemia classically come in two phases; first autonomic mediated symptoms –  the warning symptoms, then neuroglycopenic as glucose levels fall further and supply to the brain is affected.

Drag the symptoms to the appropriate box.