Poisons causing hypoglycaemia:
- Ethanol ingestion in children
Correction of symptomatic hypoglycaemia:
- Adult dose = 50ml of 50% glucose IV, repeat as required
- Paediatric dose = 2 ml/kg bolus of 10% dextrose IV, repeat as required
Deliberate self poisoning with insulin:
- Ongoing glucose infusion will be necessary as the glucose requirement will be massive. Titrate glucose to maintain euglycaemia.
- Once doses exceed 100ml of 10% dextrose over 1 hour it is wise to infuse 50% dextrose via a central line to avoid fluid overload or severe phlebitis
Deliberate self-poisoning with sulphonylureas:
- Large doses will be required until the hyperinsulinaemic state is controlled by the administration of octreotide.