From the Guidelines
The immediate treatment for hypoglycemia is to consume 15-20 grams of glucose, which is the preferred treatment for the conscious individual with blood glucose <70 mg/dL (3.9 mmol/L), as recommended by the most recent guidelines 1. This approach is based on the latest evidence from the 2023 standards of care in diabetes, which emphasizes the importance of prompt treatment to prevent further complications. The guidelines suggest that any form of carbohydrate that contains glucose may be used, but glucose is the preferred treatment.
Key Points to Consider:
- After consuming the glucose, wait 15 minutes and recheck blood glucose levels to determine if additional treatment is needed 1.
- If blood sugar remains below 70 mg/dL (3.9 mmol/L), repeat the treatment with another 15-20 grams of glucose.
- Once blood sugar returns to normal, eat a small snack containing both carbohydrates and protein if the next meal is more than an hour away to prevent recurrence of hypoglycemia.
- For severe hypoglycemia where a person is unconscious or unable to swallow safely, bystanders should not attempt to give oral treatments but instead administer glucagon via injection or nasal spray if available, or call emergency services immediately 1.
Importance of Prompt Treatment:
Prompt treatment of hypoglycemia is crucial to prevent further complications, such as neuroglycopenic symptoms, and to reduce the risk of future episodes. The guidelines emphasize the importance of ongoing assessment of cognitive function and increased vigilance for hypoglycemia by the clinician, patient, and caregivers if impaired or declining cognition is found 1.
Prevention of Future Episodes:
To prevent future episodes of hypoglycemia, individuals with diabetes or recurrent hypoglycemia should carry fast-acting carbohydrates with them at all times and be aware of the signs and symptoms of hypoglycemia. The guidelines also recommend that individuals at risk for hypoglycemia should be asked about symptomatic and asymptomatic hypoglycemia at each encounter, and that hypoglycemia unawareness or one or more episodes of severe hypoglycemia should trigger reevaluation of the treatment regimen 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 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 hypoglycemia is to administer Glucagon for Injection as soon as possible. The recommended dosage is 1 mg (1 mL) injected subcutaneously or intramuscularly into the upper arm, thigh, or buttocks, or intravenously. After the patient has responded to the treatment, oral carbohydrates should be given to restore liver glycogen and prevent recurrence of hypoglycemia 2.
From the Research
Immediate Treatment for Hypoglycemia
The immediate treatment for hypoglycemia typically involves the administration of fast-acting carbohydrates to raise blood glucose levels. According to 3, ingestion of 15 g of carbohydrate in the form of glucose or sucrose tablets or as a solution provides an effective therapy for moderately severe hypoglycemia.
Recommended Carbohydrate Sources
Some key points to consider when selecting a carbohydrate source for hypoglycemia treatment include:
- Glucose or sucrose in tablet or solution form is effective 3
- Orange juice or glucose gel may not be as effective due to slower absorption rates 3
- The American Diabetes Association recommends 15-20 g of fast-acting carbohydrates for treating mild or moderate hypoglycemia 4
Treatment Approaches
Different studies suggest various approaches to treating hypoglycemia, including:
- Ingestion of 20 g of D-glucose to correct hypoglycemia without rebound hyperglycemia 5
- Use of intranasal glucagon as a promising approach for the treatment of severe hypoglycemia 6
- Individualized treatment plans based on factors such as physical activity, fear of hypoglycemia, and hypoglycemia awareness 4
Real-Life Treatment Practices
In real-life conditions, individuals with type 1 diabetes often overtreat hypoglycemia by consuming more than 20 g of carbohydrates, with fruit juice being a popular choice 4. However, this may not always align with current guidelines, highlighting the need for ongoing education and support to optimize hypoglycemia management 7.