Hypoglycemia (cont.)
How is hypoglycemia treated?
The acute management of hypoglycemia involves
the rapid delivery of a source of easily absorbed sugar. Regular soda, juice,
lifesavers, table sugar, and the like are good options. In general, 15 grams
of glucose is the dose that is given, followed by an assessment of symptoms and a blood glucose
check if possible. If after 10 minutes there is no improvement, another 10-15
grams should be given. This can be repeated up to three times. At that point, the
patient should be considered as not responding to the therapy and an ambulance
should be called.
The equivalency of 10-15 grams of glucose (approximate servings) are:
- Four lifesavers
- 4 teaspoons of sugar
- 1/2 can of regular soda or juice
Many people like the idea of treating
hypoglycemia with cake, cookies, and brownies. However, sugar in the form of
complex carbohydrates or sugar combined with fat and protein are much too slowly
absorbed to be useful in the acute treatment of hypoglycemia.
Once the acute episode has been treated, a healthy, long-acting carbohydrate
to maintain blood sugars in the appropriate range should be consumed. Half a
sandwich is a reasonable option.
If the hypoglycemic episode has progressed to the point at which the patient
cannot or will not take anything by mouth, more drastic measures will be needed.
In many cases, a family member or roommate can be trained in the use of
glucagon. Glucagon causes a rapid release of glucose stores from the liver. It
is an injection given intramuscularly to a patient who cannot take glucose by
mouth. A response is usually seen in minutes and lasts for about 90 minutes.
Again, a long-acting source of glucose should thereafter be consumed to maintain
blood sugar levels in the safe range. If glucagon is not available and the
patient is not able to take anything by mouth, emergency services (for example 911) should be called
immediately. An intravenous route of glucose administration should be
established as soon as possible.
With a history of recurrent hypoglycemic episodes, the first step in
treatment is to assess whether the hypoglycemia is related to medications or
insulin treatment. Patients with a consistent pattern of hypoglycemia may
benefit from a medication dose adjustment. It is important that patients check blood
glucose values multiple times a day to help define whether there is a pattern
related to meals or medications.
Next: Is there anything else that should be done to manage hypoglycemia? »
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