| Choice | Drug | Dosage |
|---|---|---|
| Formulary choices | Glucose (oral) | Dose: |
| Or | ||
| Glucagon 1mg vial (GlucaGen® HypoKit) | Dose: Subcutaneous, intramuscular or intravenous injection, adult and child (over 25kg) 1mg | |
| Or | ||
| Glucose intravenous infusion | As per local trust policy |
Prescribing Notes
Acute management:
- Hypoglycaemia is defined as blood glucose of less than 4mmol/L (if not < 4mmol/L but the patient is symptomatic, give a small carbohydrate snack for symptom relief)
- If the patient is conscious, capable and co-operative, give 15-20g quick acting carbohydrate of the patient’s choice where possible. Examples are given in the ‘hypo’ leaflet
- If the patient is conscious but not capable and/or co-operative, give 2 tubes of oral glucose gel (squeezed into mouth between teeth and gums) OR glucagon 1mg IM
- Once capillary blood glucose (CBG) is above 4mmol/L, give 20g of long acting carbohydrate, e.g. 2 digestive biscuits or a slice of bread or next meal if due. If IM glucagon has been used, give 40g of long acting carbohydrate in order to replenish glycogen stores
- Adults with decreased level of consciousness due to hypoglycaemia who are unable to take oral treatment safely should be:
- given intramuscular glucagon by a trained user (intravenous glucose may be used by professionals skilled in obtaining intravenous access)
- monitored for response at 10 minutes, and then given intravenous glucose if the level of consciousness is not improving significantly
- then be given oral carbohydrate when it is safe to administer it, and placed under continued observation by a third party who has been warned of the risk of relapse