Hypoglycemia
Alerts and Notices
Synopsis

Risk factors for hypoglycemia in adults include inadequate patient education, changes in caloric intake (enteral or parenteral), improper timing of insulin with meals, decreased renal or hepatic clearance, tapering of steroids, acute illness dementia, and advanced age (older than 65 years).
In neonates, hypoglycemia may be related to endocrine deficiencies; low birth size; delayed first feeding; severe renal, liver, or heart disease; sepsis; or hereditary fructose intolerance.
Signs and symptoms depend on the causes but may be adrenergic (including agitation, tremor, hunger, weakness, palpitation, nausea, irritability, sweating, and tachycardia) or neuroglycopenic (including confusion, lethargy, paresthesia, blurred vision, headache, dizziness, behavioral changes, seizures, loss of consciousness, and coma). An infant may present with irritability, poor feeding, tachypnea, cyanosis, hypothermia, or lethargy within a few hours after birth.
Codes
ICD10CM:E16.2 – Hypoglycemia, unspecified
SNOMEDCT:
302866003 – Hypoglycemia
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
Artifactual hypoglycemia – Delayed processing of blood without an added antiglycolytic agent, particularly in patients with leukemia; patient is asymptomatic, and subsequent testing without delays in processing does not suggest hypoglycemia.Similar autonomic symptoms without hypoglycemia have a broad differential:
- Postprandial syndrome
- Cardiac arrhythmia
- Valvular heart disease (eg, aortic stenosis, mitral valve prolapse)
- Psychiatric disease (eg, anxiety disorder)
- Hyperthyroidism
- Pheochromocytoma
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:02/04/2019
Last Updated:06/06/2022
Last Updated:06/06/2022