Initiate treatment protocol for BG < 4 mmol/L

• What is the initial treatment protocol for BG < 4 mmol/L?

  Treat and then notify provider
• What is the treatment for mild to moderate hypoglycemia?

  • Oral ingestion of 15 g carbohydrate
  • Options: glucose or sucrose tabs/solution or juice (~175 mL)
  • Retest BG in 15 minutes
  • Monitor closely and re-treat if BG < 4.0
• How much carbohydrate should be ingested for mild to moderate hypoglycemia?

  15 g carbohydrate
• What should be done after treating mild to moderate hypoglycemia?

  Retest BG in 15 minutes
• What is the treatment protocol for severe hypoglycemia in a conscious patient?

  • Oral ingestion of 20 g carbohydrate
  • Options: glucose or sucrose tabs/solution or juice (~250 mL)
  • Retest BG in 15 minutes
  • Monitor closely and re-treat if BG < 4.0
• How much carbohydrate should be ingested for severe hypoglycemia in a conscious patient?

  20 g carbohydrate
• What should be done after treating severe hypoglycemia in a conscious patient?

  Retest BG in 15 minutes
• What is the treatment protocol for severe hypoglycemia in an unconscious patient?

  • If IV access: Push 20–50 mL D50W over 1-3 min
  • If no IV access: SC/IM glucagon 1 mg
  • Wait 10 minutes, re-test, administer 2nd dose if still unconscious and low
  • Consider intranasal powder
• What is the dosage of glucagon for an unconscious patient without IV access?

  1 mg SC/IM
• How long should you wait after administering glucagon before re-testing?

  Wait 10 minutes
• What is the difference in carbohydrate dosage for conscious versus unconscious severe hypoglycemia treatment?

  20 g for conscious, glucagon for unconscious