What is the dosing for glucose tablets in treating hypoglycemia?

Dosing for Glucose Tablets in Treating Hypoglycemia

For treating hypoglycemia, 15-20 grams of glucose is the recommended dose of glucose tablets, which should be administered orally to conscious individuals with blood glucose below 70 mg/dL (3.9 mmol/L). 1

Recommended Protocol for Hypoglycemia Treatment

Initial Treatment

• Administer 15-20 grams of glucose for conscious individuals with blood glucose <70 mg/dL (3.9 mmol/L) 1
• Glucose tablets are preferred over other forms of carbohydrates when available 1
• Wait 15 minutes after treatment and recheck blood glucose 1
• If hypoglycemia persists (blood glucose still <70 mg/dL), repeat the 15-20 gram glucose dose 1
• Once blood glucose begins trending upward, the individual should consume a meal or snack to prevent recurrence of hypoglycemia 1

Effectiveness of Glucose Tablets

• Glucose tablets demonstrate better resolution of symptoms within 15 minutes compared to dietary sugars such as sucrose, fructose, orange juice, jellybeans, and milk 1
• Pure glucose raises blood glucose more effectively than equivalent amounts of carbohydrates from other sources 1
• 10 grams of oral glucose can raise blood glucose by approximately 40 mg/dL over 30 minutes 1
• 20 grams of oral glucose can raise blood glucose by approximately 60 mg/dL over 45 minutes 1

Alternative Options When Glucose Tablets Are Not Available

• Any form of carbohydrate containing glucose can be used as an alternative 1
• Simple dietary sugars can be used when glucose tablets are not available 1
• Examples of alternatives providing approximately 15 grams of carbohydrates include:
  • 1 tablespoon of table sugar 1
  • 6-8 oz of apple or orange juice 1
  • 6-8 oz of regular (non-diet) soda 1
  • 1 tablespoon of honey 1
  • 15-25 jellybeans, gummy bears, or hard-shelled candies 1

Special Considerations

Monitoring After Treatment

• Initial response to treatment should be seen within 10-20 minutes 1
• Blood glucose should be evaluated again at 60 minutes after treatment, as additional treatment may be necessary 1
• Blood glucose levels typically begin to fall again at 60 minutes after glucose ingestion 1

Severe Hypoglycemia

• For severe hypoglycemia (altered mental status requiring assistance), glucagon should be administered rather than oral glucose 1
• Emergency medical services should be activated for individuals who are unable to swallow, have a seizure, or do not improve within 10 minutes of oral glucose administration 1
• Oral glucose should never be administered to individuals who are not awake or unable to swallow 1

Pediatric Considerations

• For children with suspected hypoglycemia who are awake but unwilling or unable to swallow glucose, a slurry of granulated sugar and water applied under the tongue may be reasonable 1

Common Pitfalls and Caveats

• Adding protein to carbohydrate treatment does not affect the glycemic response or prevent subsequent hypoglycemia 1
• Adding fat may delay the acute glycemic response, making it less effective for immediate treatment 1
• During hypoglycemia, gastric emptying rates are approximately twice as high as during normal blood glucose levels, which helps with rapid absorption 1
• Relying solely on subjective symptoms without checking blood glucose can lead to inappropriate treatment 1
• Failure to consume a follow-up meal or snack after initial treatment often results in recurrent hypoglycemia 1