Hypoglycemia

SoldierNurse22, BSN, RN · Apr 4, 2014

A blood sugar of 7? As in, 7mg/dL? Uhmmm..no.

Maybe they're just barely alive, but they're certainly not sitting up and talking to you. Hypoglycemia tends to manifest symptomatically anywhere from 50-70mg/dL based on the diabetic. I cannot imagine under any circumstances that someone with a blood sugar of 7 would even be conscious.

Whoatemyburger · Apr 4, 2014

Did you recheck it ? Maybe the glucometer was not working ?

Esme12, ASN, BSN, RN · Apr 4, 2014

7mg/dL NO

7 mmol/L which is 126 mg/dL. Yes.

JenniferG rN · Apr 4, 2014

7mg/d was what EMS got on scene. When she was brought the the ed it was 160. Thank you all for your input.

FutureCRNA?, BSN, RN · Apr 4, 2014

I don't think meters will read that low. Under a certain number, they usually just read "LOW."

Must be a mistake.

Esme12, ASN, BSN, RN · Apr 6, 2014

It had to be an error. Maybe it was 70. After a certain level the machines lose their accuracy. Was the patient unconscious?

JenniferG rN · Apr 7, 2014

No the patient was not unconscious- she had her eyes open. The medic on scene said she had that look in her eye "like she was looking at me with that nobody's home look." When the patient arrived to the ED she was able to tell me everything that happened at the house- even remembered hearing her boyfriend calling 911. I asked the dr if this could b correct and she said- well the patient is alive so it must be. I would like to talk to the EMT that brought the patient in to ask more about the machine he used and if it was calibrated and etc. but when I brought this up to the charge nurse she suggested I should drop it- that the patient outcome was fine (she was discharged in less than an hour after arriving) and move on. But I'm the nurse who believes in treat the patient not the machine and I look at everything as a learning and or teaching opportunity. Do you know of any articles on what happens to the body when the blood sugar is that low? And any suggestions on how I can present it to my co workers as a learning opportunity and not just to prove them or the medic wrong? Or am I just thinking to much into it?

ClearBlueOctoberSky · Apr 7, 2014

I've had a patient with a sugar of 13 that was responsive to painful stimuli. I've also had a patient start with AMS and signs of hypoglycemia with a BGL of 126. At the time, I couldn't check his sugar because my machine took a dump. I drew pre-D50 blood, gave him the D-50, and his symptoms resolved. The blood I drew was tested in the ER, and yes, the Nurses gave me heck about it. But I did treat my patient, and not the machine, which is what the Paramedics in your OP did. The number was just an evaluation tool for differential diagnosis.

Remember that everyone reacts differently to low blood sugars. For myself, my BGL could drop to the low 40's/high 30's and all I exhibit is severe crankiness and irritability. That isn't my normal personality, so I know that when I start b*** at everyone for the little things, I need to check my sugar and eat.

Same with my mom. She doesn't feel effects until she is in the 30's.

CDEWannaBe · Apr 7, 2014

I think this is on the edge of possibility.

Back when I had hypoglycemia unwareness, I could have extreme lows and still function. The current meters just read Low below 20 now (I think), but they used to give lower readings. I remember one time having a reading of 13 and walked from my office, across the street to a cafe an bought a juice. Another time I was awake with eyes open but not responsive, my husband tried to give me juice and I couldn't swallow so he sqeezed cake frosting in my cheek and spooned juice in my mouth. I came to a couple minutes later and tested about 30 mintutes after that and my reading was 15, so who knows how low I was to start.

Exteme lows with hypoglycemia unawareness are SO dangerous because patient can appear coherent but be seconds away from brain and vital organ shut down.

Hypo unawareness happens after years of high and low blood sugars. Mine occured after about 25 years with type 1 diabetes. Because of erratic blood sugars the body stops releasing adrenalin and patient becomes asymptomatic to hypoglycemia.

After getting an insulin pump about 12 years ago, the severity and fequency of my lows were drastically reduced and the hypoglycemia unawareness reversed within a couple months. I now have low below 60 mg/dl maybe twice a month and have not had a low below 40mg/dl in years. I can sense my blood sugar drops below 70 mg/dl and have the classic hypoglycemia symptoms. Thank God for modern diabetes technology. With shots I would likely have been dead instead of healthy and complication-free after 37 years with diabetes.

morte, LPN, LVN · Apr 7, 2014

is it possible that the meter was in the wrong "mode"? are they even made with both measuring systems?

FutureCRNA?, BSN, RN · Apr 7, 2014

I had one a long time ago that normally tested blood sugar, but also sort of tested your Hba1c level, except it was more of a 1 month average supposedly instead of 3ish. I'm sure there are meters out there that could give you results in either measurement system.