What does low insulin mean?

The so-called low insulin should refer to low blood sugar, which means that the blood sugar concentration of an adult is 2.8 mol when fasting. When the blood sugar of an adult is low, clinically there will be sympathetic nerve excitement, brain cell hypoxia, frequent feelings of hunger and panic, limb tremors, pale complexion and other symptoms. If it becomes more serious, it may lead to agitation and even coma.

Management of acute hypoglycemia

(1) Glucose application:

For critically ill patients with low blood sugar and coma, in order to avoid progressive changes in the condition, 50-100 ml of 50% glucose solution must be quickly injected intravenously. If necessary, repeat 1-2 times until the patient is conscious. Then, 10% glucose solution is dripped intravenously to maintain blood sugar at 8.3-11.1 mmol/L (150-200 mg/dl). The patient should be observed for 12-48 hours to facilitate the recovery of brain cells and prevent coma again. If the above conditions are not met, patients with low blood sugar and coma should not drink sugar water, which may cause suffocation. At this time, honey or jam can be applied on the patient's teeth and oral mucosa, or nasogastric feeding of sugar water is also one of the first aid measures.

It can be used simultaneously with 50% glucose solution after the onset of the disease. The general dose is 0.5-1.0 mg, which can be injected subcutaneously or intramuscularly. Consciousness is usually restored within 10-30 minutes, and repeated application is required if necessary. (3) Application of epinephrine:

When patients have severe hypoglycemia and shock and do not meet the above conditions, small to medium doses can be used, but it should be used with caution in patients with hypertension and the elderly. (4) Application of mannitol:

If the patient's blood sugar has recovered after the above treatment but remains in a coma for more than 30 minutes, it is hypoglycemia and coma may be accompanied by cerebral edema. Intravenous drip of 40g of 20% mannitol may be considered and the infusion should be completed within 20 minutes.

After high-sugar treatment, although the blood sugar has been maintained at 8.3-11.1 mmol/L, the patient is still conscious after 15-30 minutes. In order to protect the brain from damage, 100-200 mg of adrenal corticosteroids (or 10 mg of dexamethasone) can be used once every 4-8 hours, for a total of 2-3 times.