HYPOGLYCEMIA

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A 64 years old male patient came to opd with the chief complaint of sudden loss of consciousness

History of present illness:

Patient was apparently asymptomatic 15days ago. then he developed high sugars for which he went to hospital  and advised to use gliclazide 60mg &  Metformin 500mg OD. Patient was normal untill morning  then he took Gliclazide 60mg & Metformin 500mg in the morning assuming his sugars to be digh. From then he was unconcious, and his GRBS was 21mg/dl. His last meal was yesterday afternoon

HISTORY OF PAST ILLNESS :

 H/o DM since 1year, 

H/o HTN since 1yr, 

No H/o Asthma , epilepsy, TB . 

TREATMENT HISTORY :

NO history of previous medication 

PERSONAL HISTORY :

Married 

Mixed diet 

appetite normal

bowel regular

Normal micturation

No addictions

FAMILY HISTORY :

NO H/O :-HTN,DM ,EPILEPSY ,TB

GENERAL EXAMINATION :

NO pallor 

No .icterus 

 No cynosis 

 No lymphadenopathy 

 No clubbing 

No bilateral pedal edema

PHYSICAL EXAMINATION-:

.temperature-:afibrile 

.pulse rate -:87/min

.resp rate -:18/min 

.Bp -:110/60

 SYSTEMIC EXAMINATION :

CVS-; 

        S1,S2 HEARD 

        NO MURMERS 

RESPIRATORY SYSTEM-:

         No dyspnea 

          No wheeze 

          Position of trachea -;central 

ABDOMEN-:

          Shape scaphoid 

          No  Tenderness

          No palpable mass 

           No palpable spleen and liver 

CNS-:

         Consious, coherent ,cooperative 

         Speech normal

         No neck stiffness

         

SENSORY SYSTEM :

        Able to percieve-:pain , temp.

 PROVISIONAL DIAGNOSIS :

 Hypoglycemia 2° to oral hypoglycemic drugs

 

INVESTIGATIONS:

Complete blood picture

ECG, 

Complete urine examination  

RBS

HbA1c

RFT

LFT, 

USGAbdomen

2D ECHO

TREATMENT:

Glucose replacement

Octreotide