Hypoglycemia

Question 1

What is the blood glucose concentration threshold for treatment guidelines?

Answer 1

Less than 3.5 mmol/litre

Question 2

How much glucose should be administered orally if the patient is conscious?

Answer 2

10-20 g of glucose PO

Question 3

What is the IV glucose dosage for adults?

Answer 3

100 ml of 10% glucose IV

Question 4

What is the IV glucose dosage for children?

Answer 4

2 ml/kg of 10% glucose IV

Question 5

What should be administered if IV access cannot be gained?

Answer 5

Glucagon

Question 6

What is the dose of glucagon for patients aged five years and over?

Answer 6

1 mg of glucagon IM

Question 7

What is the dose of glucagon for children aged less than five years?

Answer 7

0.5 mg of glucagon IM

Question 8

How often should glucose measurements be repeated?

Answer 8

Every ten minutes

Question 9

What is the minimum blood glucose concentration required ten minutes after treatment?

Answer 9

Greater than 3.5 mmol/litre

Question 10

What criteria must be met for a patient to not require ambulance transport after hypoglycaemia treatment?

Answer 10

All of the following must be met:
* Known diabetes
* Isolated single episode
* Not due to overdose of insulin or oral hypoglycaemics
* Fully recovers and can mobilise normally
* Blood glucose > 3.5 mmol/litre after treatment
* Competent adult can stay with patient for 4 hours
* Patient eats a meal
* Given hypoglycaemia information sheet

Question 11

What should happen if a patient under 18 years old is recently diagnosed with diabetes?

Answer 11

Treatment review should occur within 24 hours if feasible

Question 12

What are common causes of hypoglycaemia?

Answer 12

Usually occurs in patients taking:
* Insulin
* Oral hypoglycaemic medicine

Less common causes include:
* Severe sepsis
* Poisoning with glucose-lowering medicines
* Liver failure

Question 13

What should not be used to measure blood glucose concentration?

Answer 13

The patient’s glucose meter

Question 14

What type of blood should be used for measuring glucose concentration?

Answer 14

Capillary blood

Question 15

What is the recommended form of oral glucose for hypoglycaemia treatment?

Answer 15

Simple carbohydrate that is rapidly absorbed

Question 16

Give examples of oral glucose sources.

Answer 16

• 10% glucose
• Glucose tablets or gel
• Sugar dissolved in water
• ‘Non-diet’ jam
• ‘Non-diet’ soft drinks

Question 17

How much glucose is approximately in half a cup of ‘non-diet’ fruit juice?

Answer 17

10-20 g of glucose

Question 18

What should be documented after administering oral glucose?

Answer 18

Approximate grams of oral glucose or description of food ingested

Question 19

How can glucose gel be administered to a baby or small child?

Answer 19

Spread on gums, tongue, and inside of cheeks

Question 20

Why is it important for the patient to eat a meal after glucose treatment?

Answer 20

To prevent hypoglycaemia from recurring as glucose is metabolised

Question 21

What type of carbohydrates are preferred for the meal after hypoglycaemia treatment?

Answer 21

Complex carbohydrates such as brown rice, whole grain bread, porridge, or beans

Question 22

In what circumstance would glucagon be ineffective

Answer 22

If patient has no glycogen stores such as in young children, has sepsis or haven’t eaten in over 12 hours

Question 23

Hypoglycaemia in children under the age of five is more likely due too

Answer 23

Illness with no food intake, sepsis or poisoning with hypoglycaemic medications