From the Guidelines
The immediate treatment for confusion due to hypoglycemia is to consume 15-20 grams of fast-acting carbohydrates, as recommended by the most recent guidelines 1. This can be achieved by drinking 4 ounces (120 ml) of fruit juice or regular soda, eating 4 teaspoons of sugar or honey, taking 3-4 glucose tablets, or consuming glucose gel according to package instructions. After taking these quick-acting carbohydrates, wait about 15 minutes and check blood glucose levels if possible. If symptoms persist or blood glucose remains below 70 mg/dL (3.9 mmol/L), repeat the treatment. Once blood sugar has normalized and symptoms improve, follow up with a small snack containing protein and complex carbohydrates, such as crackers with peanut butter or a half sandwich, to prevent recurrence. Hypoglycemia causes confusion because the brain depends heavily on glucose for energy, and when levels drop too low, brain function becomes impaired. For individuals with diabetes who experience frequent hypoglycemic episodes, carrying glucose tablets or gel is recommended 1. If the person is unconscious or unable to swallow safely, do not give oral treatments and seek emergency medical help immediately, as they may need injectable glucagon or intravenous glucose. Key points to consider in the treatment of hypoglycemia include:
- The threshold for treating hypoglycemia is a blood glucose level <70 mg/dL (3.9 mmol/L) 1
- Glucagon should be prescribed for all individuals at increased risk of level 2 or 3 hypoglycemia 1
- Hypoglycemia unawareness or one or more episodes of level 3 hypoglycemia should trigger hypoglycemia avoidance education and reevaluation and adjustment of the treatment plan to decrease hypoglycemia 1
From the FDA Drug Label
Administer Glucagon for Injection as soon as possible when severe hypoglycemia is recognized Immediately after reconstitution, inject the solution subcutaneously or intramuscularly in the upper arm, thigh, or buttocks The recommended dosage is 1 mg (1 mL) injected subcutaneously or intramuscularly into the upper arm, thigh, or buttocks, or intravenously Call for emergency assistance immediately after administering the dose. When the patient has responded to the treatment and is able to swallow, give oral carbohydrates to restore the liver glycogen and prevent recurrence of hypoglycemia.
The immediate treatment for confusion due to hypoglycemia is to administer glucagon for injection as soon as possible. The recommended dosage for adults and pediatric patients weighing more than 25 kg is 1 mg (1 mL) injected subcutaneously or intramuscularly. After administering the dose, call for emergency assistance immediately. Once the patient has responded to the treatment and is able to swallow, give oral carbohydrates to restore liver glycogen and prevent recurrence of hypoglycemia 2.
From the Research
Immediate Treatment for Confusion due to Hypoglycemia
The immediate treatment for confusion due to hypoglycemia involves administering glucose or glucagon to raise blood glucose levels.
- Glucagon is an emergency medication that can quickly raise glucose in people who are unconscious or unable to consume glucose due to severe hypoglycemia 3.
- For individuals who are conscious and able to swallow, oral glucose administration is recommended 4.
- If the person is unable to take glucose by mouth, glucagon can be administered via injection or nasal spray 3, 5.
- It is essential to act quickly, as severe hypoglycemia can lead to serious complications, including death 6, 7.
Administration Routes for Glucose
Different routes of glucose administration have been studied, including:
- Sublingual (under the tongue) administration, which may be effective in certain situations, such as in children with hypoglycemia and symptoms of concomitant malaria or respiratory tract infection 4.
- Buccal (between the cheek and gum) administration, which may not be as effective as oral administration 4.
- Oral administration, which is generally recommended for conscious individuals who are able to swallow 4.
Importance of Prompt Treatment
Prompt treatment of hypoglycemia is crucial to prevent serious complications and ensure the well-being of individuals with diabetes 6, 7, 5.
- Delaying treatment can lead to severe hypoglycemia, which requires assistance from another person to administer carbohydrate, glucagon, or take other corrective actions to assure neurologic recovery 6.
- Education and regular review are essential for individuals with diabetes and their caregivers to recognize the symptoms of hypoglycemia and take appropriate action 7.