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Blood Sugar Level

 
 
 
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Overview

The blood sugar should be tested in every acutely unwell person, mainly because hypoglycaemia is an underdiagnosed cause of reduced consciousness, and can mimic stroke symptoms.

Hypoglycaemia

A blood sugar level of ≤3.9 is generally considered to indicate hypoglycaemia. This is a clinical emergency and should be rapidly treated.
  • Causes of Hypoglycaemia

  • Diabetics

  • Insulin - excessive insulin dosing, regular insulin dosing despite reduced carbohydrate intake / missing a meal, use of an insulin infusion perioperatively without dextrose infusion
  • Oral hypoglycaemics - sulfonylureas
  • Non-Diabetics

  • Insulinoma
  • Symptoms

  • Autonomic (mild / moderate hypoglycaemia) - hunger, anxiety, diaphoresis, tremor, palpitations, paraesthesiae
  • Neuroglycopaenic (severe hypoglycaemia) - fatigue, confusion, visual changes, seizures, unconsciousness

Hyperglycaemia

  • Symptoms

  • Fatigue
  • Polyuria
  • Polydipsia
  • Thirst
  • Weight loss
  • Acute Complications

  • Diabetic ketoacidosis (DKA)
  • Hyperglycaemic hyperosmolar state (HHS)
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