Hypoglycemia physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]

Main signs of hypoglycemia are tachycardia and ventricular arrhythmia. Neurological manifestations include altered mental status, hypotonia, focal or general motor deficit and jerks. Neonatal hypoglycemia signs include large for gestational age, hepatomegaly in Beckwith-Wiedemann syndrome and glycogen storage diseases. Ambiguous genitalia, hypertension, hyponatremia, and hyperkalemia are found in congenital adrenal insufficiency.

• Macrosomia in infancy may indicate hyperinsulinism.^[1]
• In older children and adults, moderately severe hypoglycemia can resemble mania, mental illness, drug intoxication, or drunkenness. In the elderly, hypoglycemia can produce focal stroke-like effects or a hard-to-define malaise.

• Hypothermia may be present in newborns

• Heart rate: Tachycardia may be present.

• Rhythm: Pulse is usually regular.
• Ventricular arrhythmia is fatal if occurred.^[2]

• Tachypnea

• Pallor

• Dilated pupils

• Cyanosis may be present in newborns

• Mental status may be altered^[3]
• Myoclonus
• Hypotonia
• Ataxia
• Incoordination
• Focal or general motor deficit
• Paralysis
• Hemiparesis

• Large for gestational age^[1]
• Beckwith-Wiedemann syndrome signs: hemihypertrophy, hepatomegaly, and macroglossia^[4]
• Congenital adrenal insufficiency: ambiguous genitalia, hypertension, hyponatremia, and hyperkalemia^[5]
• Congenital hypopituitarism: Midline facial defects and micropenis
• Glycogen storage diseases: Hepatomegaly.