The treatment of diabetes mellitus often includes the administration of insulin and/or an oral hypoglycemic agent to improve cellular glucose uptake.55 The use of insulin, meglitinides, or sulfonylureas in the absence of adequate intake of carbohydrates is the most common cause of hypoglycemia. Conditions of increased metabolism such as fever, heavy exercise, anxiety, infection, and pain lead can lead to hypoglycemia.55
Signs and symptoms of hypoglycemia are neurogenic- and neuroglycopenia-related. Neuroglycopenic signs and symptoms result from the direct central nervous system (CNS) deprivation of glucose, and include behavioral changes, confusion, fatigue, seizure, coma, and potential death if not immediately corrected. Neurogenic signs and symptoms can either be adrenergic (e.g., tremors, palpitations, anxiety) or cholinergic (e.g., hunger, diaphoresis, paresthesias).55
