Hypoglycemia

Question 1

Definition

Answer 1

low blood glucose (BG):

• Mild: 2.8-3.9 mmol/L
• Severe: <2.8 mmol/L

Question 2

Signs & symptoms

Answer 2

• Trembling
• Tachycardia / Palpitations
• Diaphoresis
• Anxiety / Nervousness
• Hunger
• Nausea
• Tingling
• Changes with coordination
• Difficulty concentrating
• Confusion
• Weakness / Lethargy
• Drowsiness
• Vision changes
• Difficulty speaking
• Headache
• Dizziness
• Malaise (restlessness)

Question 3

What to do (mild/moderate hypoglycemia): 2.8-3.9 mmol/L

Answer 3

• check BG with the glucometer
• treat by providing 15 g of glucose tabs (x3-4) or gel (x1): gels are preferably used for unconscious patients, dysphagia, or if there’s any other risk of aspiration
• check BG again after 15 mins. repeat steps 1 & 2 until BG is >4.0 mmol/L
• provide meal/snack (complex carbs such as crackers, cheese, juice, etc)
• inform MRP as per facility policy
• document incident

STAY WITH THE PATIENT. Make sure that the patient is stable enough before leaving the patient to grab something

Question 4

What to do (severe conscious hypoglycemia): <2.8 mmol/L BG

Answer 4

• treat by providing 20 g of glucose tabs (x4) or gel (x1): gels are preferably used for unconscious patients, dysphagia, or if there’s any other risk of aspiration
• check BG again after 15 mins. repeat steps 1 & 2 until BG is >4.0 mmol/L
• provide meal/snack (complex carbs such as crackers, cheese, juice, etc)
• inform MRP as per facility policy
• document incident

STAY WITH THE PATIENT. Make sure that the patient is stable enough before leaving the patient to grab something

Question 5

What to do (severe UNCONSCIOUS hypoglycemia): <2.8 mmol/L

Answer 5

• IV Glucose: 25g provided as 50mL D50W given over 1-3 min OR 1mg Glucagon SC/IM (max is 2 glucagon inj)
• notify MRP verbally ASAP
• monitor & repeat IV Glucose in 10 min if BG is <4mmol
• document incident