Treatment and Prevention
Symptoms of non-severe hypoglycaemia can be treated with 15 g fast-acting carbohydrate,4 such as a few small sweets or cup of juice, milk, or sweetened drink. Treatment is also advised in asymptomatic patients with blood glucose in the “alert range” of 3.5 to 3.9 mmol/L (63 to 70 mmol/L). If glucose levels remain low after 15 minutes, treatment should be repeated.1,2
In a conscious person, severe hypoglycaemia can be treated in a similar manner with 20 g fast-acting carbohydrates. If glucose remains low after 45 minutes, IV glucose can be considered if available.3 In an unconscious person, hypoglycaemia is treated with IV glucose or with glucagon.
References
- Deary IJ et al. Partitioning the symptoms of hypoglycaemia using multi-sample confirmatory factor analysis. Diabetologia 1993;36:771.
- Cryer PE. Management of hypoglycemia during treatment of diabetes mellitus. UpToDate review, last updated May 15, 2014.
- Canadian Diabetes Association 2013 clinical practice guidelines. Chapter 14: Hypoglycaemia. Can J Diabet 2013;A3.
- The hospital management of hypoglycaemia in adults with diabetes mellitus. NHS
[U.K.] guidelines 2010. Accessed at http://www.diabetologists-abcd.org.uk/jbds/JBDS_IP_Hypo_Adults.pdf
McIntyre HD et al. Dose Adjustment for Normal Eating: A Role for the Expert Patient? Med J Aust 2010; 192:637.
Eng C et al. Glucagon-like peptide-1 receptor agonist and basal insulin combination treatment for the management of type 2 diabetes: a systematic review and meta-analysis. Lancet 2014;384:2228.
UK Hypoglycaemia Study Group. Risk of hypoglycaemia in types 1 and 2 diabetes: effects of treatment modalities and their duration. Diabetologia 2007;50:1140.
Edelman SV, Blose JS. the impact of nocturnal hypoglycemia on clinical and cost-related issues in patients with type 1 and type 2 diabetes. Diabetes Educ 2014;40:269.