Acute Metabolic Complications



Hypoglycemia is a common complication of drug treatment and is a particular risk in insulin-treated patients. Severe episodes can lead to serious complications and may be potentially fatal if left untreated.

  • Hypoglycemia is likely to occur under the following circumstances
  • Omission of meals or inadequate food intake
  • With unaccustomed physical exercise
  • Over treatment with insulin or sulphonylureas
  • Ingestion of alcohol particularly without food
  • Diminishing insulin requirements due to impaired renal function


  • Hypoglycemia is a medical emergency and should be treated promptly
  • Blood glucose should be measured using glucose-sensitive reagent strips to confirm the diagnosis in suspected
  • If blood measurement is not immediately available, treat as hypoglycemia
  • In mild cases, the person with diabetes should by taking in glucose or a sweetened drink, which may have to be repeated as necessary
  • If the patient is confused or unconscious, give 10-20mls of 20% or 50% glucose intravenously
  • When IV is not available or possible, give glucagon 1mg intramuscularly or subcutaneously 

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