6.1.4 Treatment of hypoglycaemia

Guidelines for the management of hypoglycaemia for adults

Conscious patient

  • Initially 10-20g glucose by mouth (if necessary repeated at 10-15 minutes)
    • Glucose tablets = 3 tablets
    • Granulated sugar = 2 teaspoons
    • Sugar lumps = 3 lumps
    • Milk = 200ml
    • Glucose drink = 50-55ml
    • Cola drink (not diet) =90ml
  • Use only glucose/dextrose if patient taking acarbose
Glucagon
  • Injection 1mg vial with prefilled syringe (£11.52)

Indications

  • Acute hypoglycaemia

Dose

  • Adult and child over 8 years (or body-weight over 25 kg), 1mg; child under 8 years (or body-weight under 25 kg), 500 micrograms; if no response within 10 minutes intravenous glucose must be given

Notes

  1. The GlucaGen HypoKit should be stored at a temperature of 2-8°C. The user can store GlucaGen HypoKit at a temperature not exceeding 25°C for 18 months provided that the expiry date is not exceeded (as per manufacturer's SPC).
GlucoGel®

(Glucose)

  • Oral gel, 3x25g tubes (10g glucose per tube) (£7.16)

Notes

  1. May be a useful treatment to be administered by family or carers. It is only appropriate if a patient's carer could not manage to administer a glucagen injection.

Chronic hypoglycaemia

Diazoxide
  • Tablets 50mg (£46.45 = 100 tablets)
  • Injection 15 mg in 1ml, 20ml amp

Notes

  1. Diazoxide, administered by mouth, is useful in the management of patients with chronic hypoglycaemia from excess endogenous insulin secretion, either from an islet cell tumour or islet cell hyperplasia. It has no place in the management of acute hypoglycaemia.

 

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