Hypoglycaemia
Overview
- The BNF provides comprehensive guidance on hypoglycaemia in the ‘Medical emergencies in the community’ section
Clinical features
- Clinical features of hypoglycaemia include: sweating, shaking, tingling lips, pallor, fatigue, heart palpitations, rapid or irregular heart rate, dizziness, weakness, hunger, anxiety, irritability, clumsiness, impaired vision
Key points from the BNF (adults and children over 2 years)
- Initially glucose or sucrose (10–20 g) is given by mouth either in liquid or solid form. Proprietary products of quick-acting carbohydrate are available on prescription and include GlucoGel®, Dextrogel®, GlucoBoost® and Rapilose® gel. Alternatively, it is available from sugar/sugar lumps, sweets and non-diet versions of soft drinks such as Lucozade® Energy Original, Coca-Cola® and Ribena® Blackcurrant. Note: the sugar content of such drinks is subject to change and therefore individual product labels should be checked
- This may be repeated after 10–15 minutes
- After initial treatment, the person should have a snack, or their next meal (if due), ensuring it contains the appropriate slower release carbohydrates
- If the person is drowsy, unable to swallow safely or unconscious, give nothing by mouth — call 999, and place them in the recovery position if they are breathing normally. Where the oral route cannot be used, or oral carbohydrate has not worked, glucagon (GlucaGen® HypoKit) 1 mg by subcutaneous or intramuscular injection (0.5 mg for a child under 25 kg) may be given by a trained person while waiting for the ambulance. Glucagon will not work if liver glycogen is depleted — for example after prolonged fasting or in alcohol-induced hypoglycaemia. Call 999 if the person has not recovered within 10 minutes of a glucagon injection. NB: the onward step of intravenous glucose is hospital/prescriber territory, not a community first-aid measure