Hypoglycemia Management

Treatment and Prevention

• The American Diabetes Association recommends treating hypoglycemia (blood glucose ≤70 mg/dL) with 15-20g of glucose, with blood glucose rechecked after 15 minutes and treatment repeated if hypoglycemia persists 1, 2
• Insulin secretagogues (e.g., sulfonylureas) can cause hypoglycemia, according to the American Diabetes Association 1
• Alcohol consumption can inhibit gluconeogenesis and contribute to hypoglycemia, as noted by the American Diabetes Association 3
• Prolonged fasting can contribute to hypoglycemia, as reported by the American Diabetes Association 4
• Post-bariatric surgery patients are at risk of hypoglycemia due to altered gut hormone response, according to the American Diabetes Association 3
• For conscious patients with hypoglycemia, the American Diabetes Association recommends administering 15-20g of glucose orally, with pure glucose preferred over other carbohydrates 1, 2, 5
• The American Diabetes Association suggests that patients using automated insulin delivery systems may require a lower dose of 5-10g carbohydrates for hypoglycemia treatment, except in cases of exercise-induced hypoglycemia 1, 3
• After hypoglycemia treatment, the American Diabetes Association recommends consuming a meal or snack with complex carbohydrates and protein to prevent recurrence 3
• For severe hypoglycemia (unconscious patient), the American Diabetes Association indicates that glucagon is the preferred treatment, and all individuals at high risk of hypoglycemia should be prescribed glucagon 1, 2
• Family members or caregivers of patients at high risk of hypoglycemia should be instructed on glucagon administration, as recommended by the American Diabetes Association 1
• Young children with type 1 diabetes and elderly individuals are particularly vulnerable to hypoglycemia due to reduced ability to recognize symptoms, according to the American Diabetes Association 1
• Individualized glycemic goals, patient education, and bedtime snacks may be necessary for special populations, such as young children and elderly individuals, as noted by the American Diabetes Association 1
• Avoiding prolonged fasting periods can help prevent hypoglycemia, as recommended by the American Diabetes Association 4
• Implementing consistent meal timing when on fixed insulin regimens can help prevent hypoglycemia, according to the American Diabetes Association 6
• Including protein and/or fat with meals can slow carbohydrate absorption and help prevent hypoglycemia, as noted by the American Diabetes Association 3
• Teaching recognition of hypoglycemia symptoms and instructing patients to always carry a source of fast-acting carbohydrates can help prevent and manage hypoglycemia, as recommended by the American Diabetes Association 3
• For those with recurrent hypoglycemia, the American Diabetes Association suggests considering continuous glucose monitoring 4
• Treating hypoglycemia with foods high in protein without adequate glucose content can worsen the condition, as warned by the American Diabetes Association 1, 2
• Failing to recheck blood glucose after initial treatment can lead to recurrent hypoglycemia, as noted by the American Diabetes Association 2
• Not carrying fast-acting glucose sources for emergency treatment can increase the risk of severe hypoglycemia, as warned by the American Diabetes Association 3