Acute mountain sickness (AMS) can present with a wide variety of symptoms in unacclimatized persons who rapidly ascend to altitudes > 2500 m. [ncbi.nlm.nih.gov]

The blood sample may have been sent some time after the initial presentation. [lifeinthefastlane.com]

Patients presenting with hypoglycemia due to ingestion of a first-, second-, or third-generation hypoglycemic agent will have drug present in serum greater than the minimum effective concentration (see Reference Values). [mayomedicallaboratories.com]

• Falling

  When your blood sugar begins to fall, a hormone tells your liver to release glucose. In most people, this raises blood sugar. If it doesn't, you have hypoglycemia, and your blood sugar can be dangerously low. [icdlist.com]

  Namely, while a fall in blood glucose is normally rapidly detected, counter-regulatory mechanisms are recruited to restore normoglycemia. [atlasofscience.org]

  If the dose is too high, blood sugar levels can fall too far, leading to hypoglycemia. Hypoglycemia can also occur if the person exercises more than usual or does not eat enough. [medicalnewstoday.com]

  Efficacy – In one large study of 284 patients with type 2 diabetes treated with Rezulin, the fall in mean fasting blood glucose concentration was significant but not dramatic over 12 weeks; patients treated with placebo had a fall in blood glucose concentration [bouldermedicalcenter.com]

  The patient should be concerned about the possibility of developing hypoglycaemia when the SMBG is falling rapidly or is ≤70 mg/dl. [slideshare.net]

• Weight Loss

  In addition to causing modest weight loss, metformin has two other advantages as compared with sulfonylureas. They are: It is less likely to cause hypoglycemia. [bouldermedicalcenter.com]

  GLP-1 is also associated with enhanced satiety, reduced food intake, and weight loss or neutrality; it may also preserve β-cell morphology and function. [touchendocrinology.com]

  An additional advantage of gliflozin therapy is a weight loss in people with overweight and obesity. There was a reduction in body weight in obese type 2 diabetes, approximately 2 kg at 24 weeks of therapy. [openaccessjournals.com]

  The additional disutility associated with injectable treatments in type 2 diabetic patients [ 46 ], and in particular with exenatide which requires two injections per day, as well as the risk of nausea and weight loss in older frail adults [ 47 ], decreases [journals.plos.org]

  Weight loss or failure to gain weight. 3. Polyphagia. 4. Dehydration. [clinicaladvisor.com]

• Fishing

  This is why a high-fiber diet with moderate amounts of slowly-digested carbohydrate, good quality protein, and healthy fats (eg omega-3 fatty acids from fish) is recommended for people with impaired glucose control, such as those with type 2 diabetes. [lifeextension.com]

  Some foods that are high in protein include beef, pork, fish, poultry (chicken and turkey), beans, and nuts. Eat a variety of vegetables with your meals. When should I contact my healthcare provider? You have blurred vision or vision changes. [drugs.com]

  Patients should: * avoiding overeating * never skipping breakfast * including protein in all meals and snacks, preferably from sources low in fat, such as the white meat of chicken or turkey, most fish, soy products, or skim milk * restricting intake [checkorphan.org]

  […] hypoglycemia, the NIH recommends taking the following steps: [1] Avoiding or limiting sugar intake; [20] Exercising regularly, as exercise increases sugar uptake which decreases excessive insulin release; Eating a variety of foods, including meat, poultry, fish [en.wikipedia.org]

  Seaquist ER, Anderson J, Childs B, Cryer P, Dagogo-Jack S, Fish L, et al. Hypoglycemia and Diabetes: A Report of Workgroup of the American Diabetes Association and The Endocrine Society. [journals.plos.org]

• Pallor

  Clinical features : 1) General signs and symptoms: Dizziness, blurred vision, pallor, nausea, and light-headedness. 2) Perspiration, palpitations, tremor, hunger, anxiety, and profuse perspiration; these are caused by sympathetic stimulation (starting [empendium.com]

  Signs of hypoglycemia • Common signs of hypoglycemia include : 1. diaphoresis and pallor. 2. [slideshare.net]

  […] include cognitive impairment, behavioral/personality changes, difficulties speaking, dizziness, blurred vision, weakness, incoordination, hemiplegia, arrhythmias, seizures, coma, and even death. 38-39 Common signs of hypoglycemia include diaphoresis and pallor [ahcmedia.com]

• Hypothermia

  We assume that antipsychotic drug-induced hypoglycemia and hypothermia are underdiagnosed. Antipsychotic drugs are, however, widely used and these rare adverse-effects may occur in the clinical practice. [ncbi.nlm.nih.gov]

  Loss of consciousness may be accompanied by bilateral plantar reflex, muscle tension, hypothermia. In the course of severe hypoglycemia may also appear unusual symptoms. [openaccessjournals.com]

• Fracture

  Possible Complications Health problems that may result from Cushing disease include: Compression fractures in the spine Diabetes High blood pressure Infections Kidney stones Mood or other psychiatric problems When to Contact a Medical Professional Call [mclarenhealthplan.org]

  Generalized skin eruption due to drugs and medicaments L27.1 -- Localized skin eruption due to drugs and medicaments M10.2 -- Drug-induced gout M32.0 -- Drug-induced systemic lupus erythematosus M80.4 -- Drug-induced osteoporosis with pathological fracture [briancbennett.com]

  These include fluid retention and congestive heart failure [ 39 ], bone fractures [ 40 ], and possibly bladder cancer [ 41 ]. [journals.plos.org]

  Hypoglycemia can lead to injuries, falls with fractures, traffic accidents. Severe hypoglycemia is a complication with psychological and social consequences to the patients and their families [ 7, 8 ]. [openaccessjournals.com]

  The neuroglycopenic symptoms of hypoglycemia can increase the risk of falls, fracture, and nursing home placement. 42 Because glucose is an obligate metabolic fuel for the brain, hypoglycemia can have potentially devastating effects on the brain. 9,16 [ahcmedia.com]

• Hunger

  The condition is caused by several types of drugs, including bactrim, beta-blockers, insulin, and MAO inhibitors The signs and symptoms of Drug-Induced Hypoglycemia may include anxiety, hunger, and irritability. [dovemed.com]

  Signs include Hunger Shakiness Dizziness Confusion Difficulty speaking Feeling anxious or weak In people with diabetes, hypoglycemia is often a side effect of diabetes medicines. Eating or drinking something with carbohydrates can help. [icdlist.com]

  Well Photo Credit Illustration by Celia Jacobs Outrunning Hunger Intense exercise may change the way certain neurons influence our appetite and metabolism. [nytimes.com]

  Medications that can cause drug-induced hypoglycemia include: Bactrim (an antibiotic) Beta-blockers Haloperidol Insulin MAO inhibitors Metformin when used with sulfonylureas Pentamidine Quinidine Quinine Sulfonylureas Symptoms Return to top Anxiety Hunger [pacificschoolserver.org]

  Clinical features : 1) General signs and symptoms: Dizziness, blurred vision, pallor, nausea, and light-headedness. 2) Perspiration, palpitations, tremor, hunger, anxiety, and profuse perspiration; these are caused by sympathetic stimulation (starting [empendium.com]

• Suggestibility

  However, symptoms suggestive of hypoglycemia are far more common than the condition itself. [merckmanuals.com]

  Some researchers suggest that certain people may be more sensitive to the body’s normal release of the hormone epinephrine, which causes many of the symptoms of hypoglycemia. [en.wikipedia.org]

  Some in vivo studies suggested that stimulation of the pancreatic D2 receptors inhibits insulin release, which inhibitory effect on insulin secretion was reverted by the addition of D2 receptor antagonists. [atlasofscience.org]

  Technetium uptake scintigraphy of the thyroid was suggestive of Graves' disease, as it showed enlargement of both lobes of thyroid with homogeneous increased tracer uptake of 17.2% (normal 1%–4%) in both lobes [Figure 1]. [cjhr.org]

  Useful For Suggests clinical disorders or settings where the test may be helpful Evaluation of suspected insulinoma characterized by hypoglycemia and increased plasma insulin concentration. [mayomedicallaboratories.com]

• Fear

  Type 1 diabetes among adolescents: Reduced diabetes self-care caused by social fear and fear of hypoglycemia. Diabetes Educ 2009;35:465–75. Haugstvedt A,Wentzel-Larsen T, GraueM, et al. [guidelines.diabetes.ca]

  Patients who reported HEs had a significantly lower mean utility score (0.78 versus 0.86, p 35 The magnitude of fear of hypoglycemia is associated with the severity and frequency of HEs. 39 Fear of hypoglycemia may promote compensatory behaviors such [touchendocrinology.com]

  In patients with diabetes, the fear of hypoglycemia exceeds the fear of long-term complications. 2 Pathophysiology In T1DM and advanced T2DM, glucose counterregulation is compromised by the impaired secretion of insulin, glucagon, and epinephrine, breaching [uspharmacist.com]

  Patient concerns about hypoglycemia should be addressed and discussed because fear of hypoglycemia can be a major barrier to glycemic control. [ahcmedia.com]

  Assessment of the impact of fear of hypoglycemic episodes on glycemic and hypoglycemia management. Can J Diabetes 2005;29;186–192. View Article Google Scholar 27. Bullano MF, Fisher MD, Grochulski WD, Menditto L, Willey VJ. [journals.plos.org]

• Confusion

  These similarities can lead to confusion in the diagnosis of hypoglycemia versus AMS, particularly for diabetics ascending to altitude. [ncbi.nlm.nih.gov]

  Signs include Hunger Shakiness Dizziness Confusion Difficulty speaking Feeling anxious or weak In people with diabetes, hypoglycemia is often a side effect of diabetes medicines. Eating or drinking something with carbohydrates can help. [icdlist.com]

  She is pleasant and slightly confused, although she can be reoriented. Her daughter, who accompanied her to the hospital, says this is her baseline state. [americannursetoday.com]

  Upon physical examination, she appears diaphoretic, with weakness, confusion, tremulousness, and palpitations. She is treated with glucose to maintain a level of above 50 mg/dL, and she responds without long-term sequelae. [the-hospitalist.org]

  […] inhibitors Metformin when used with sulfonylureas Pentamidine Quinidine Quinine Sulfonylureas Symptoms Return to top Anxiety Hunger Irritability Nightmares Palpitations Shakiness Sweating Symptoms of long-term (chronic) hypoglycemia can include: Coma Confusion [pacificschoolserver.org]

• Seizure

  The patient suffered from severe and protracted hypoglycaemia, complicated by a tonic–clonic seizure 7 days after escalation to therapeutic co-trimoxazole. Endogenous hyperinsulinaemia was confirmed and was attributed to co-trimoxazole use. [casereports.bmj.com]

  Patients can be asymptomatic or have symptoms such as dizziness, fatigue, emotional lability, seizures and coma. Hypoglycemia can result from a variety of etiologies; this patient suffered from drug-induced hypoglycemia. [synapse.ucsf.edu]

  Differential Diagnosis • Neurologic: CVA/TIA, seizure disorder • Drug/alcohol intoxication • Psychosis, depression 65. [slideshare.net]

  Hunger Headaches Irritability Pounding heart ; racing pulse Pale skin Sweating Trembling Weakness Anxiety Without treatment, you might get more severe symptoms, including: Poor coordination Poor concentration Numbness in mouth and tongue Passing out Seizures [webmd.com]

  Symptoms include anxiety, tremulousness, nausea, sweating, palpitation, and hunger.3 More severe symptoms related to compromised central nervous system function include weakness, fatigue, confusion, seizures, focal neurologic deficits, and coma. [the-hospitalist.org]

• Dizziness

  Signs include Hunger Shakiness Dizziness Confusion Difficulty speaking Feeling anxious or weak In people with diabetes, hypoglycemia is often a side effect of diabetes medicines. Eating or drinking something with carbohydrates can help. [icdlist.com]

  Family members reported that after snorting cocaine and then using Valium pills earlier that day, the patient began reporting dizziness, confusion and difficulty speaking before going to his room to lie down. [synapse.ucsf.edu]

  They include: fatigue headaches pale skin confusion dizziness irritability mood changes clumsy or jerky movements If a child shows any of the above signs or symptoms, they should see a doctor as soon as possible. [medicalnewstoday.com]

  Blurred vision or changes in vision Dizziness, lightheadedness, or shakiness Fatigue and weakness Fast or pounding heartbeat Sweating more than usual Headache Nausea or hunger Anxiety, Irritability, or confusion How is non-diabetic hypoglycemia diagnosed [drugs.com]

  Dizziness Chloroquine, Quinine, Mefloquine, Halofantrine Could be due to high fever, dehydration and postural hypotension. [malariasite.com]

• Altered Mental Status

  Severe hypoglycemia : Altered mental status that requires assistance of a third party to actively administer carbohydrates, glucagon, or take other corrective actions. This usually requires an active follow-up even with hospital admission. [empendium.com]

  Answer and interpretation It is traditionally advocated that thiamine 100mg IV be given prior to administering a bolus of glucose to the patient with altered mental status. [lifeinthefastlane.com]

  His further hospital course was complicated by profound steroid-induced myopathy, severe chronic skin GVHD, tacrolimus-associated hemolytic uremic syndrome, and two self-limiting episodes of altered mental status changes, for which no medical cause could [nature.com]

  Drug-induced hypoglycemia is a significant adverse effect that should be included in the differential diagnosis of hypoglycemia and considered whenever patients present with altered mental status. [academic.oup.com]

  The formal definition of hypoglycemia is a condition characterized by a reduction in either plasma glucose concentration or its tissue utilization to a level that may induce symptoms or signs such as altered mental status and/or sympathetic nervous system [touchendocrinology.com]

• Cognitive Impairment

  Severe hypoglycaemia and cognitive impairment in older patients with diabetes: The Fremantle Diabetes Study. Diabetologia 2009;52:1808–15. Zhang Z, Lovato J, Battapady H, et al. [guidelines.diabetes.ca]

  Neuroglycopenic symptoms  Neuroglycopenic symptoms of hypoglycemia are the direct result of central nervous system (CNS) glucose deprivation.  They include behavioral changes, confusion, fatigue, loss of consciousness, cognitive impairment, somnolence [slideshare.net]

  impairment in young children and elderly patients with diabetes, but the extent of these effects are unknown in other age groups. [ahcmedia.com]

  Recurrent nocturnal HEs may impair cognitive function. 27 The increasing prevalence of hypoglycemia could pose a threat to the ability of patients with diabetes to drive. [touchendocrinology.com]

Only those non-diabetic individuals with documented Whipple's triad should undergo evaluation and management of hypoglycemia 2 to avoid unnecessary workup and costs. [ahcmedia.com]

• Some patients have symptoms but normal blood glucoses; they need no further workup, in spite of their insistence. 20. [slideshare.net]

• Fasting Hypoglycemia

  Fasting hypoglycemia Nesidioblastosis is a rare cause of fasting hypoglycemia in infants and an extremely rare cause in adults. [emedicine.medscape.com]

  These tests may also be done to find the cause of your hypoglycemia. Fasting tests may be done. You may have an overnight fasting test or a 72-hour fasting test. After you have fasted overnight, your blood sugar levels will be tested 2 times. [drugs.com]

  Rare hereditary enzyme deficiencies can lead to fructose intolerance and reactive hypoglycemia. 3 Fasting (Postabsorptive) Hypoglycemia This condition may be diagnosed when the serum glucose concentration is below 50 mg/dL after overnight fasting, between [uspharmacist.com]

  The antibodies generally appear a few weeks following the initiation of the drug and may result in both postprandial and fasting hypoglycemia. [cjhr.org]

  […] prolonged fasting for recurrent hypoglycemia (especially if investigations were not obtained on the presenting episode of hypoglycemia) tests for insulinomas — absence of C-peptide suppression following insulin administration, pancreatic arterial calcium-stimulation [lifeinthefastlane.com]

• Insulin Increased

  Insulinoma : A tumor in the pancreas can cause the pancreas to produce too much insulin. Increased activity : Increasing levels of physical activity can lower blood sugar levels for some time. [medicalnewstoday.com]

  […] after exercise. 3,58 Conditions in which sensitivity to insulin is increased. [ahcmedia.com]

Treatment Return to top You will be given glucose. The doctor will review your diabetes treatment plan to help prevent future problems. Outlook (Prognosis) Return to top The outlook is good if the hypoglycemia is promptly detected and treated. [pacificschoolserver.org]

The kind of treatment depends on why you have low blood sugar. [icdlist.com]

Significant metabolic derangements (DKA or HHS): Treatment should be initiated urgently and is identical to the treatment of DKA or HHS in children with either type 1 or type 2 diabetes. [clinicaladvisor.com]

A case is described in which the oral hypoglycemic agent acetohexamide, instead of acetazolamide, was mistakenly self-administered for the prophylaxis and treatment of altitude illness. [ncbi.nlm.nih.gov]

Treatment Top Acute Treatment 1. Mild hypoglycemia : Intake of fast-acting carbohydrates (eg, 10-15 g of glucose in tablets or gel) or foods/fluids (fruit juice, hard bar candy); this may be repeated when necessary. [empendium.com]

The prognosis is good, if the condition is treated in a prompt manner Drug-Induced Hypoglycemia can be prevented in non-diabetic individuals by avoiding drugs intended to reduce blood glucose levels, as well as through proper management of diet and exercise [dovemed.com]

Outlook (Prognosis) Return to top The outlook is good if the hypoglycemia is promptly detected and treated. However, long-term and repeated episodes of hypoglycemia may damage the brain and nerves. [pacificschoolserver.org]

Outlook (Prognosis) Untreated, Cushing disease can cause severe illness, even death. Removal of the tumor may lead to full recovery, but the tumor can grow back. [mclarenhealthplan.org]

Prognosis - Hypoglycemia- leucine-induced Like diabetes, there is no cure for reactive hypoglycemia, only ways to control it. [checkorphan.org]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10data.com]

Hypoglycemia can result from a variety of etiologies; this patient suffered from drug-induced hypoglycemia. Sulfonylureas are medications used in patients with type-2 diabetes to increase the release of endogenous insulin. [synapse.ucsf.edu]

(Etiology) The direct cause of Drug-Induced Hypoglycemia is the unregulated use of one of several types of medications that cause blood sugar levels to drop. [dovemed.com]

Last Reviewed: December 19, 2017 Last Updated: January 22, 2017 Definition and Etiology Top Drug-induced hypoglycemia is a plasma glucose level regardless of symptoms of hypoglycemia. [empendium.com]

JAMA 285 : 437 – 443 5 2000 Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. [academic.oup.com]

Epidemiology of severe hypoglycemia in the diabetes control and complications trial. Am J Med 1991;90:450–9. Davis EA, Keating B, Byrne GC, et al. [guidelines.diabetes.ca]

Epidemiology of severe hypoglycemia in the diabetes control and complications trial. The DCCT Research Group. Am J Med 1991;90:450-459. 60. Allen C, et al. Risk factors for frequent and severe hypoglycemia in type 1 diabetes. [ahcmedia.com]

Epidemiology Hypoglycemia is common in type 1 diabetes, especially in patients receiving intensive therapy, in whom the risk of severe hypoglycemia is increased more than threefold. [slideshare.net]

In this article, we review pertinent clinical information on the incidence of drug-induced hypoglycemia and discuss the underlying pathophysiological mechanisms involved. [spectrum.diabetesjournals.org]

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test The metabolic and hormonal profiles of insulinoma and sulfonylurea-induced hypoglycemia are identical. [mayomedicallaboratories.com]

Hypoglycemia in type 2 diabetes: Pathophysiology, frequency, and effects of different treatment modalities. Diabetes Care 2005;28:2948-2961. 52. Gangji AS, et al. [ahcmedia.com]

Considering the magnitude of this problem, it is imperative to understand the underlying pathophysiological mechanisms by which a non-antidiabetic drug can cause hypoglycemia. [jmedicalcasereports.biomedcentral.com]

Not only should physicians be keenly aware of this potential iatrogenic complication but they should also be fully engaged in understanding the pathophysiological mechanisms. [f1000research.com]

Prevention Return to top For people with diabetes, strict control of blood sugar is important. [pacificschoolserver.org]

The prognosis is good, if the condition is treated in a prompt manner Drug-Induced Hypoglycemia can be prevented in non-diabetic individuals by avoiding drugs intended to reduce blood glucose levels, as well as through proper management of diet and exercise [dovemed.com]

Research: Preventing Unnecessary Costs of Drug-Induced Hypoglycemia in Older Adults with Ty... 1 Reply - 249 Views Posts: 7156 Joined: 10/30/09 Research: Preventing Unnecessary Costs of Drug-Induced Hypoglycemia in Older Adults with Type 2 Diabetes in [community.diabetes.org]

Subsequently, the patient should consume complex (long-lasting) carbohydrates to prevent recurrent hypoglycemia (eg, bread, potatoes, cereal, nuts, peanuts). [empendium.com]

Prevention Eating regular meals that include complex carbohydrates can prevent hypoglycemia for most people. [medicalnewstoday.com]