Hypoglycemia, Diabetic - Medications
Hypoglycemia, Diabetic - Medications
Hypoglycemia, Diabetic
General Measures
Individualize blood glucose targets
Glucose is the preferred treatment; however, any form of carbohydrate that contains glucose should be effective (7)[A].
Any sugar-containing food or beverage that can be rapidly absorbed: Juice (4¨C6 ounces), candy (5¨C6 pieces of hard candy), or non¨Cdiet soda
OTC glucose tablets or gels
Glucagon: People in close contact with people with diabetes should be instructed in using an emergency glucagons kit (7)[A].
Diet
If alcohol is consumed, combine with food to reduce risk of hypoglycemia.
Protein does not slow absorption of carbohydrates.
Fats may slow absorption of carbohydrates and may retard and then prolong the acute glycemic response (8)[B].
Activity
Rest until glucose is normal.
Medication
First Line
General:
Glucose:
Oral administration of small-molecule sugars (saccharose/glucose)
~60¨C90 carbohydrate calories (15¨C20 g glucose) repeated every 15 minutes until blood sugar is ¡Ý100 mg/dL (5.55 mmol/L)
Takes ~15 minutes for carbohydrates to be digested and enter blood stream as glucose
In patients with loss of consciousness at home:
Administer glucagon IM or SC in the deltoid or anterior thigh:
<5 years old: 0.25¨C0.50 mg
5¨C10 years old: 0.50¨C1 mg
>10 years: 1 mg
In unconscious patients, if emergency medical personnel are present or patient hospitalized:
Give 1/2 ampule 50% dextrose every 5¨C10 minutes until patient awakens.
Then feed orally and/or administer 5% dextrose IV at level that will maintain blood glucose >100 mg/dL.
Patients with hypoglycemia secondary to oral hypoglycemics should be monitored for 24¨C48 hours, because hypoglycemia may recur after apparent clinical recovery.
Contraindications: None
Significant possible interactions:
Treatment may cause hyperglycemia (Somogyi phenomenon).
Clearance of certain oral hypoglycemics from plasma may be prolonged in persons with liver disease.