hypoglycemic shock


hypoglycemic shock

Shock produced by extremely low blood sugars (less than 40 mg/dl), usually caused by an injection of an excessive amount of insulin, failure to eat after an insulin injection, or rarely by an insulin-secreting tumor of the pancreas. Insulin-related hypoglycemic shock may be intentionally induced in the treatment of certain psychiatric conditions. Synonym: insulin shock See: hypoglycemia

Patient care

All unconscious patients should be treated for presumptive hypoglycemia with an injection of D50. Once the patient is conscious, glucose is given by mouth to attain the desired glucose level. The rescue therapy is followed by a carbohydrate and protein snack to maintain the desired level.

The stabilized patient's immediate past history should be reviewed, looking for triggering factors. The patient and family can then be taught ways to avoid such situations in the future or to manage them before hypoglycemia again becomes this serious. If insulin levels need to be adjusted, the patient's preprandial glucose levels for the preceding 24 hr must be reviewed. The patient and family are assisted in processing the event. Their treatment actions are given positive reinforcement, correcting any errors such as inability to recognize early symptoms of insulin shock, overcorrection of insulin deficiency, or use of food products that are absorbed too slowly.

See also: shock