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[3] [2] Hypoglycemia is especially common in those in the intensive care unit or those in whom food and drink is withheld as a part of their treatment plan. [3] [17] Sepsis, a common cause of hypoglycemia in serious illness, can lead to hypoglycemia through many ways. [3] [17] In a state of sepsis, the body uses large amounts of glucose for energy.
People with type 1 diabetes mellitus who must take insulin in full replacement doses are most vulnerable to episodes of hypoglycemia (low blood glucose levels). This can occur if a person takes too much insulin or diabetic medication, does strenuous exercise without eating additional food, misses meals, consumes too much alcohol, or consumes alcohol without food. [5]
Severe hypoglycemia rarely, if ever, occurs in people with diabetes treated only with diet, exercise, or insulin sensitizers. For people with insulin-requiring diabetes, hypoglycemia is one of the recurrent hazards of treatment. It limits the achievability of normal glucoses with current treatment methods.
The coma cocktail is thought to have been created in United States as a first line treatment for an unconscious patient in an era where intensive care was new and difficult to maintain. Original coma cocktails included methylxanthines , physostigmine , physical stimulation (such as cold water baths or ammonium carbonate (" smelling salts ...
The hypoglycemia (pathologically low glucose levels) that resulted from insulin coma therapy made patients extremely restless, sweaty, and liable to further convulsions and "after-shocks". In addition, patients invariably emerged from the long course of treatment "grossly obese", [5] probably due to glucose rescue-induced glycogen storage ...
The purpose of the off-label 'mini-dose' is to avoid an emergency condition that may require glucagon rescue. This might be needed in cases such as when a diabetic child is injected with insulin before breakfast, eats, and then vomits and cannot eat again: with the injected insulin working its way into the bloodstream and no carbohydrate to balance, there may soon be a hypoglycemic emergency.
Often, the recommended treatment is a combination of lifestyle changes such as increasing exercise and healthy eating, along with medications to help control the BG levels in the long term. [2] In addition to management of the diabetes, patients are recommended to have routine follow up with specialist to manage possible common complications ...
In the elderly, hypoglycemia can produce focal stroke-like effects or a hard-to-define malaise. [medical citation needed] The symptoms of a single person do tend to be similar from episode to episode. In the large majority of cases, hypoglycemia severe enough to cause seizures or unconsciousness can be reversed without obvious harm to the brain.