[Diabetic coma and hypoglycemia in children. What to do when in an emergency].
With a few very rare exceptions, hypoglycemia and diabetic coma almost always occur in patients with diabetes mellitus, and are among the most common emergencies in children. For the emergency physician, it is important, on the basis of a specific history-taking and information from, for example, family members, supplemented by a clinical examination done in the light of knowledge of the typical symptoms of each of the entities, to determine whether hypoglycemia or diabetic coma is presenting. The most important technical examination is the measurement of blood glucose. In the event of hypoglycemia, the first therapeutic measure is the administration of sugar--in the case of a comatose patient via a venous line. The s.c. or i.m. administration of glucagon to achieve short-term improvement might be considered. In the event of a diabetic coma, abundant electrolyte solution is initially needed, followed by i.v. insulin. Referral to hospital is mandatory.
Riedl
B
B
Facharzt für Allgemeinmedizin, Wenzenbach, Lehrbeauftragter für Allgemeinmedizin der Univ. Regensburg. riedl-med-oek@t-online.de
D000367:Age Factors; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003926:Diabetic Coma / Q000175:diagnosis / Q000188:drug therapy; D004630:Emergencies; D005934:Glucagon / Q000008:administration & dosage; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis / Q000188:drug therapy; D007231:Infant, Newborn; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D007328:Insulin / Q000008:administration & dosage; D008297:Male
D007328:Insulin; D005934:Glucagon