What is the recommended dose of dextrose (dextrose) tablets for treating hypoglycemia?

Recommended Dose of Dextrose Tablets for Treating Hypoglycemia

For a person with suspected hypoglycemia who is awake and able to swallow, 15-20 grams of oral glucose in the form of dextrose tablets is the recommended dose to treat hypoglycemia. 1

First-Line Treatment Options

• Glucose tablets are preferred over other forms of dietary sugars when available for treating hypoglycemia 1
• The recommended dose of 15-20 grams of oral glucose can rapidly restore blood glucose levels 1
• Blood glucose and treatment should be repeated at 15-minute intervals until blood glucose levels return to normal (≥70 mg/dL) 1

Alternative Options When Glucose Tablets Are Unavailable

If glucose tablets are not available, the following alternatives containing at least 15 grams of simple sugars can be used:

• 1 tablespoon table sugar 1
• 6-8 oz apple or orange juice 1
• 6-8 oz regular (non-diet) soda 1
• 1 tablespoon honey 1
• 15-25 jellybeans, gummy bears, or hard-shelled candies 1
• Other dietary sugars such as Skittles or Mentos 1

Special Considerations for Children

• For children with suspected hypoglycemia who are awake but unwilling or unable to swallow glucose, it may be reasonable to apply a slurry of granulated sugar and water under the tongue 1
• Sublingual glucose administration may be considered for children who may be uncooperative with oral glucose administration 1

Important Clinical Cautions

• Oral glucose should not be administered to people who are not awake or not able to swallow 1
• Emergency medical services should be activated for a person with hypoglycemia who is unable to swallow, has a seizure, or does not improve within 10 minutes of oral glucose administration 1
• For severe hypoglycemia in patients who cannot take oral glucose, parenteral options include:
  • Glucagon for intramuscular injection 1, 2
  • Intravenous dextrose for healthcare settings 1, 3

Monitoring After Treatment

• After initial treatment, blood glucose should be rechecked at 15-minute intervals 1
• If blood glucose remains <70 mg/dL, treatment should be repeated 1
• Any episode of severe hypoglycemia requires reevaluation of the diabetes management plan 1

Evidence on Effectiveness

• Glucose tablets have demonstrated better resolution of symptoms at 15 minutes after treatment compared to dietary sugars such as sucrose, fructose, orange juice, and milk 1
• In emergency settings, intravenous dextrose (10% concentration) administered in 5g aliquots has been shown to be as effective as 50% dextrose with fewer adverse effects 4, 5
• Recent research shows that both 10% and 25% dextrose solutions are as effective as 50% dextrose in achieving normal mental status in emergency department settings 6

By following these guidelines, hypoglycemia can be effectively treated while minimizing the risk of overcorrection and subsequent hyperglycemia.