Key messages

• Given the wide range of 'normal' blood glucose values, diagnosis of pathological hypoglycemia depends on the clinical recovery from neuroglycopenic symptoms after an intravenous infusion of glucose.

• Glucose 25 g given intravenously (50 ml of 50 per cent glucose) usually reawakens a comatose hypoglycemic patient in 5 to 10 min.

• Intramuscular glucagon (1 mg) is an effective and portable alternative to intravenous glucose for the majority of hypoglycemic episodes in insulin-dependent diabetics.

• In the malnourished, thiamine deficiency will be accelerated if circulating glucose substrate is rapidly restored, causing acute and potentially fatal Wernicke's encephalopathy.

• Prolonged hypoglycemia, particularly in association with hypoxemia and hypotension, leads to cerebral edema. Recovery may be delayed despite the attainment of normoglycemia.

Sleep Apnea

Sleep Apnea

Have You Been Told Over And Over Again That You Snore A Lot, But You Choose To Ignore It? Have you been experiencing lack of sleep at night and find yourself waking up in the wee hours of the morning to find yourself gasping for air?

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