What is the treatment for hypoglycemia?

From the Guidelines

For a blood glucose level of 31 mg/dL, immediate treatment with 15-20 grams of fast-acting carbohydrates is necessary, and if the level remains below 70 mg/dL after 15 minutes, the treatment should be repeated. Given the severity of the hypoglycemia, it's crucial to act quickly to prevent further complications. The treatment approach should follow the most recent guidelines, which emphasize the importance of prompt intervention for hypoglycemia, as indicated in the study 1.

Key Considerations for Treatment:

• Fast-acting carbohydrates such as glucose tablets, fruit juice, or honey should be administered first.
• The individual should recheck their blood glucose level 15 minutes after the initial treatment.
• If the blood glucose level remains below 70 mg/dL, the treatment with fast-acting carbohydrates should be repeated.
• Once the blood glucose level normalizes, a snack containing protein and complex carbohydrates should be consumed to prevent recurrence of hypoglycemia.

Severe Hypoglycemia:

In cases where the individual is unconscious or unable to swallow safely, emergency treatment with glucagon is necessary, as outlined in the guidelines 1. Glucagon can be administered via injection, nasal spray, or auto-injector, with typical adult doses being 1 mg. It is essential for caregivers to know how to administer glucagon and to call emergency services immediately in such situations.

Prevention of Recurrence:

For individuals with recurrent hypoglycemia, addressing the underlying cause is crucial. This may involve adjusting diabetes medications, treating hormone deficiencies, or modifying diet, as suggested in the study 1. Regular monitoring and education on hypoglycemia management can also help in preventing future episodes.

From the FDA Drug Label

2 DOSAGE & ADMINISTRATION

1. 1 Important Administration Instructions for Using the Glucagon Emergency Kit for Low Blood Sugar to Treat Severe Hypoglycemia Glucagon for Injection is for subcutaneous, intramuscular, or intravenous injection. Administer intravenously ONLY under medical supervision. Instruct patients and their caregivers on the signs and symptoms of severe hypoglycemia Because severe hypoglycemia requires the help of others to recover, instruct the patient to inform those around them about Glucagon for Injection and its Instructions for Use. Administer Glucagon for Injection as soon as possible when severe hypoglycemia is recognized Instruct the patient or caregiver to read the Instructions for Use at the time they receive a prescription for Glucagon for Injection Emphasize the following instructions to the patient or caregiver: Using the supplied prefilled syringe, carefully insert the needle through the rubber stopper of the vial containing Glucagon for Injection powder and inject all the liquid from the syringe into the vial. Shake the vial gently until the powder is completely dissolved and no particles remain in the fluid The reconstituted solution should be clear and colorless. Inspect visually for particulate matter and discoloration. If the resulting solution is cloudy or contains particulate matter do not use. The reconstituted solution is 1 mg per mL glucagon. Immediately after reconstitution, inject the solution subcutaneously or intramuscularly in the upper arm, thigh, or buttocks In addition, healthcare providers may administer 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. Discard any unused portion.

The treatment for hypoglycemia (Rbs 31 mg/dl) is Glucagon for Injection. The recommended dosage is:

• 1 mg (1 mL) injected subcutaneously or intramuscularly into the upper arm, thigh, or buttocks, or intravenously for adults and pediatric patients weighing more than 25 kg or for pediatric patients with unknown weight 6 years and older.
• 0.5 mg (0.5 mL) injected subcutaneously or intramuscularly into the upper arm, thigh, or buttocks, or intravenously for pediatric patients weighing less than 25 kg or for pediatric patients with unknown weight less than 6 years of age. If there has been no response after 15 minutes, an additional dose of Glucagon for Injection may be administered using a new kit while waiting for emergency assistance 2.

From the Research

Treatment for Hypoglycemia

The treatment for hypoglycemia typically involves the administration of carbohydrates or glucagon to raise blood glucose levels.

• Carbohydrates can be administered orally, such as glucose tablets or solutions, or intravenously, such as dextrose, in severe cases 3, 4.
• Glucagon can be administered intramuscularly, subcutaneously, or intranasally, and is effective in treating severe hypoglycemia 5, 4.

Administration Methods

Different administration methods have varying effects on blood glucose levels:

• Oral carbohydrates, such as glucose tablets or solutions, can raise blood glucose levels effectively, but may have a slower onset of action compared to intravenous administration 3.
• Intravenous dextrose can raise blood glucose levels quickly, but may have a shorter duration of action compared to oral carbohydrates 4.
• Intranasal glucagon has been shown to be effective in treating severe hypoglycemia, with a faster onset of action compared to oral carbohydrates and a longer duration of action compared to intravenous dextrose 5.

Prevention and Management

Prevention and management of hypoglycemia are crucial to minimize its occurrence and consequences:

• Individualized glycemic goals and flexible treatment regimens can help prevent hypoglycemia 6, 7.
• Patient education and awareness of hypoglycemia symptoms and treatment options are essential for effective management 6, 7.
• Avoiding hypoglycemia for a period of 2-3 weeks can help reverse hypoglycemia unawareness in patients with recurrent hypoglycemia 6.