Hypoglycaemia - A little glucose in a dangerous thing

Hypoglycaemia occurs when blood glucose levels drop below 2.8 mmol/L (50 mg/dL). It is usually caused by administration of excess insulin relative to circulating glucose levels in patients with diabetes mellitus; it may also occur in patients treated with sulphonylureas. In diabetes, biochemical responses (which decrease insulin and increase glucose) and early symptoms of hypoglycaemia, such as sweating, are often blunted. This can lead to severe hypoglycaemia. The risk of hypoglycaemia can be minimised with education, regular eating, medication adjustment and careful plasma glucose monitoring, especially at night and during intensive glycaemic control. Hypoglycaemia is treated with oral glucose, intramuscular or subcutaneous glucagon, or intravenous glucose.