Hypoglycemia-noninsulin Induced: Difference between revisions

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* Code [[Anoxic Encephalopathy 2nd to hypoglycemia]] if applicable
* Code [[Anoxic Encephalopathy 2nd to hypoglycemia]] if applicable


{{Discussion}}
== criteria/definition ==
What criteria does a collector use to code this as an admit or acquired DX either to med ward or to an ICU?
*is there a certain glucose range you use when considering whether the event is hypoglycemia?  Does this change depending on whether or not the pt is diabetic?
*do you consider the episode hypoglycemia if it is treated only with juice/juice & sugar?


**I have pasted the criteria/definition of hypoglycemia provided by Dr. Garland below:  --[[User:LKolesar|LKolesar]] 06:53, 2015 December 11 (CST)
The “normal range” for serum glucose is 3.9-6.1 mmol/L.  However, it is important to remember that this does not necessarily mean that values lower that 3.9 represent hypoglycemia, or that values above it do not.  The two factors that determine what is problematic for a given person are: (i) her/his usual blood glucose, and (ii) the presence of symptoms due to absolute or relative hypoglycemia.  So, some normal persons have values as low as 2.2 without any symptoms and this would not be considered abnormal for that person if they had no hypoglycemic symptoms.  On the other hand, a poorly controlled diabetic who usually runs with a very high blood glucose could develop symptoms of hypoglycemia with values within (or even above) the usual “normal range” listed above.
 
Hypoglycemia -- criteria/definition
 
The “normal range” for serum glucose is 3.9-6.1 mmol/L.  However, it is important to remember that this does not necessarily mean that values lower that 3.9 represent hypoglycemia, or that values above it do not.  The two factors that determine what is problematic for a given person are: (i) her/his usual blood glucose, and (ii) the presence of symptoms due to abolute or relative hypoglycemia.  So, some normal persons have values as low as 2.2 without any symptoms and this would not be considered abnormal for that person if they had no hypoglycemic symptoms.  On the other hand, a poorly controlled diabetic who usually runs with a very high blood glucose could develop symptoms of hypoglycemia with values within (or even above) the usual “normal range” listed above.


So, criteria for identifying hypoglycemia are the presence of ALL OF THE FOLLOWING:   
So, criteria for identifying hypoglycemia are the presence of ALL OF THE FOLLOWING:   
 
# Absolute or relative hypoglycemia -- by relative we mean values significantly lower than that person usually runs  PLUS     
1. Absolute or relative hypoglycemia -- by relative we mean values significantly lower than that person usually runs  PLUS     
# Symptoms of hypoglycemia (see below)  PLUS
2. Symptoms of hypoglycemia (see below)  PLUS
# The symptoms were alleviated by giving the patient sugar (either iv or in any oral preparation such as a candy or orange juice)
3. The symptoms were alleviated by giving the patient sugar (either iv or in any oral preparation such as a candy or orange juice)


Symptoms of hypoglycemia fall into 2 main categories:
Symptoms of hypoglycemia fall into 2 main categories:
(a) neurogenic symptoms can include tremor, palpitations, and anxiety/arousal, sweating, hunger, and paresthesias
* neurogenic symptoms can include tremor, palpitations, and anxiety/arousal, sweating, hunger, and paresthesias
(b) neuroglycopenic symptoms can include cognitive impairment, behavioral changes, psychomotor abnormalities,  seizure and coma
* neuroglycopenic symptoms can include cognitive impairment, behavioral changes, psychomotor abnormalities,  seizure and coma
 
 
 
 
 
 
 
 
 
{{discuss@task}}


[[Category: Hypoglycemia]]
[[Category: Hypoglycemia]]

Revision as of 12:46, 15 December 2015

Legacy Content

This page is about the pre-ICD10 diagnosis coding schema. See the ICD10 Diagnosis List, or the following for similar diagnoses in ICD10:

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edit dx infobox
Category/Organ
System:
Category: Metabolic (old)

Type:

[[:Category: Medical Problem (old)]][[Category: Medical Problem (old)]]

Main Diagnosis: Hypoglycemia-noninsulin Induced
Sub Diagnosis: HYPOGLYCEMIA-NONINSULIN INDUCED
Diagnosis Code: 33100 - Hypoglycemia-noninsulin Induced
Comorbid Diagnosis: No
Charlson Comorbid coding (pre ICD10): 0
Program: CC & Med
Status: Currently Collected


criteria/definition

The “normal range” for serum glucose is 3.9-6.1 mmol/L. However, it is important to remember that this does not necessarily mean that values lower that 3.9 represent hypoglycemia, or that values above it do not. The two factors that determine what is problematic for a given person are: (i) her/his usual blood glucose, and (ii) the presence of symptoms due to absolute or relative hypoglycemia. So, some normal persons have values as low as 2.2 without any symptoms and this would not be considered abnormal for that person if they had no hypoglycemic symptoms. On the other hand, a poorly controlled diabetic who usually runs with a very high blood glucose could develop symptoms of hypoglycemia with values within (or even above) the usual “normal range” listed above.

So, criteria for identifying hypoglycemia are the presence of ALL OF THE FOLLOWING:

  1. Absolute or relative hypoglycemia -- by relative we mean values significantly lower than that person usually runs PLUS
  2. Symptoms of hypoglycemia (see below) PLUS
  3. The symptoms were alleviated by giving the patient sugar (either iv or in any oral preparation such as a candy or orange juice)

Symptoms of hypoglycemia fall into 2 main categories:

  • neurogenic symptoms can include tremor, palpitations, and anxiety/arousal, sweating, hunger, and paresthesias
  • neuroglycopenic symptoms can include cognitive impairment, behavioral changes, psychomotor abnormalities, seizure and coma