Epidemiology
Etiology
Pathophysiology
Clinical features
Diagnostics
Treatment
- Alert and oriented patients
- Oral glucose 15–20 g
- Fast-acting carbohydrates (e.g., glucose tablets, candy, or fruit juice)
- Patients with altered mental status (or impaired oral intake)
- IV dextrose (e.g., D50W): Repeat after 15 minutes if hypoglycemia persists; multiple doses may be required.
- Adults: 50% dextrose
- Children (excluding neonates): 10% dextrose OR 25% dextrose
- IM glucagon: if neither oral nor IV routes of administering glucose are feasible
- Glucagon therapy is only successful if the patient’s glycogen reserves have not been depleted, as glucagon elevates endogenous glucose production via hepatic glycogenolysis and gluconeogenesis.
- IV dextrose (e.g., D50W): Repeat after 15 minutes if hypoglycemia persists; multiple doses may be required.
Tip
For patients with type 1 diabetes presenting with hypoglycemia and using insulin pumps, do not discontinue insulin pumps and treat hypoglycemia as usual. Removing the insulin pump puts patients at risk for diabetic ketoacidosis.
Warning
Avoid giving orange juice to patients with CKD on a low-potassium diet as it is high in potassium.