CLINICAL MANIFESTATION
• Serum glucose less than 3.3mmol/dl
• All patients presenting with altered mentation should get a bedside blood glucose measurement
• Overdose with long acting insulin such as premixed insulin (often 30/70) produces maximum effect 2-12 hrs after administration and the effect lasts for 24 hrs.
CLINICAL MANAGEMENT
• Monitor and support ABCs
• Administer thiamine 100mg if there is altered level of consciousness in the presence of malnutrition or history of alcohol abuse.
• Monitor and correct HYPOKALEMIA particularly after insulin overdose
• Administer a bolus of 50% dextrose PO/ IV or Glucagon IM 1mg
• Monitor blood glucose hourly and . . .
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