Logged in as | Logout

Multilingual Support:

Concerns

Hypoglycemia

Causes

Prevention

Signs and symptoms

Action

Hypoglycemia

Hypoglycemia may be associated with clinical manifestations when plasma glucose drops <72 mg/dL (4.0 mmol/L). This condition is most commonly found among patients with diabetes mellitus.

Causes

  • too much insulin
  • excessive alcohol consumption
  • excessive strenuous exercise
  • missed or delayed meals
  • inadequate carbohydrate intake
  • medication error
  • other illness

Prevention

  • if the patient is diabetic, make sure:
    • the patient has eaten 2 hours prior to the dental appointment
    • the patient is not treated during the time period when his/her insulin is peaking
  • perform a fingerstick plasma glucose test on all patients with a history of hypoglycemic episodes

Signs and symptoms

Autonomic:
  • sweating
  • trembling
  • tachycardia
  • anxiety
  • nausea
Neuroglycopenic:
  • dizziness
  • confusion
  • difficulty speaking
  • headache
  • inability to concentrate
  • weakness
  • blurred vision

Action

  • discontinue dental treatment
  • assess responsiveness
  • place the patient in a supine position
  • monitor blood pressure, pulse and respiratory rate
  • If the patient is conscious:
    • 15 gm of carbohydrates (e.g. 3 tsp of granulated sugar, orange juice, cake icing)
  • If the patient is unconscious:
    • 25 gm of glucose, 50 mL D50W IV push; 1 mg of glucagon (SC, IM, or IV)
  • arrange for home escort
  • notify the patient’s primary care provider
  • call later to check on patient

OK