Hypoglycemia Treatment - Non responding Hypoglycemia Therapies Side effects

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APPROACH TO HYPOGLYCEMIA

Related topics

Hypoglycemia : Clinical Features

Hypoglycemia : Major Causes

Hyperinsulinism and Ketotic Hypoglycemia

Glycogen storage disorder and Fatty acid oxidation defects

Fasting hypoglycemia and Erratic hypoglycemia

Dr Ira Shah
M.D, DCH(Gold Medalist), FCPS, DNB

Treatment of hypoglycemia
In neonates with persistent hypoglycemia due to hyperinsulinism - subtotal pancreatectomy may be needed.

For treatment of acute neonatal or infantile hypoglycemia -

IV glucose - 2 ml/kg of D₁₀w followed by continuous infusion at 6 - 8 mg/kg/min.

For persistent infantile hypoglycemia, IV glucose infusion may be even up to 8 - 15 mg/kg/min.

Glucagon - 0.03 - 0.1 mg/kg/dose IV/IM for patients without initial IV access.

Glucagon has no effects in status of starvation, adrenal insufficiency or chronic hypoglycemia.

Other therapies for nonresponding hypoglycemia in neonates-

IV Hydrocortisone- 5 mg/kg/24 hrs in 3 divided doses

Oral Diazoxide - 10 - 25 mg/kg/24 hrs in 4 divided doses.

Side effects - hirsutism, edema, nausea, electrolyte disturbance, hypoglycemia.

Octreotide (Long acting somatostatin analog) - 20 - 50 mcg SC every 6 - 12 hrs.

Side effects - poor growth, vomiting, diarrhea and hepatic dysfunction.

Reference -
Nelson Textbook of Pediatrics Ed 15. W.B.Saunders.

See Expertise Views On "Hypoglycemia"

Last created on 23-02-2001
Last updated on 27-04-2007

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