management in an adult

Last reviewed 01/2018

  • finger prick test to establish the diagnosis

  • if the patient is drowsy or fitting then:
    • give 50 ml of 50% glucose i.v., or alternatively glucagon 1 mg i.v./i.m./s.c.
    • recheck the glucose by stick test after 5 mins and repeat again at 30 min

  • if recurrent hypoglycaemia or condition that predisposes recurrent hypoglycaemia, for example sepsis, sulphonylurea excess, liver disease
    • start 10% dextrose at 1000 ml over 12 hr, via a large antecubital vein or central line
    • titrate the rate to keep the blood glucose level at 5-10 mM
    • if sulphonylurea excess then maintain the glucose infusion for 24 hr and before tailing off, the blood glucose is tested routinely for 3 days
    • higher concentrations of dextrose may be necessary (via a central vein) if the 10% dextrose is not sufficient.