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Symptoms: sweating, tremulousness, palpitations, nausea, anxiety, blurred vision, confusion ± coma.
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Causes: insulin toxicity, oral hypoglycaemic toxicity, other drugs (e.g. quinine, salicylates), alcohol, fasting, tumours (e.g. insulinoma), Addison disease, post gastrectomy.
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Treatment: glucagon 1 mg SC or IM with sugar under tongue or other sweets, or 25–50 mL, 50% dextrose (or glucose) or both if severe.