Investigating hypos
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75% of episodes will be explainable if an adequate history is taken (from BOTH patient AND significant other)
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If not, or if episodes are recurrent, consider:
| Renal dysfunction | check U&E’s / eGFR / urine protein dip |
| Steroid deficiency (iatrogenic withdrawal) | check 0900 cortisol if in doubt |
| Thyroid deficiency | check TFT’s (and if abnormal other autoimmune markers) |
| Weight loss from any cause | FBC / ESR / CRP / Liver Function / CXR / other imaging |
| Cognitive Dysfunction (may be quite subtle) | formalised 30question MMT initially |
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Recurrent hypoglycaemia in Type 1 DM may represent variable requirements and the need to consider referral to the Intensified Insulin Therapy team for formalised assessment of needs via structured monitoring and assessment plans +/- CGMS(Continuouse Glucose Monitoring system) +/- assessment for CSII (Continuous Subcutaneous Insulin Infusion) (as per NICE guidelines)