• Hypoglycaemia SSOU Guideline


    Blood glucose < 3.5mmol/l on arrival to ED, now normalized requiring ongoing glucose monitoring and supplementation

    Admission Criteria

    • Diabetic patient with simple, identifi ed cause for hypoglycaemia eg: accidental overdose / inadequate oral intake
    • BSL controlled in ED


    Exclusion Criteria

    • Unlikely to tolerate diet < 24 hours
    • Oral hypoglycaemic or intentional insulin overdose
    • Unable to monitor BSL on discharge
    • Febrile / septic
    • Persisting altered conscious state/ neurological deficit
    • Major co-morbidities



    • Glucose (BSL every 30 minutes until stable for > 2 hours
    • FBE
    • UEC
    • Urinalysis
    • Investigation of precipitants as indicated clinically


    Suggested Medications

    50% Dextrose is no longer used for treatment of hypoglycaemia at Bendigo Health
    Encourage early oral feeding 
     Drug  Dose  Frequency  Route 
     Dextrose 10% boluses  250mL   prn if BSL < 4mmol/L and conscious state affected   IV 
     Dextrose 10% boluses  15/mL/kg/hr  IV infusion IV
     Consider Glucagon 1mL prn if BSL < 4 mmol/L IV/IM


    Specific Observations

    • 30 minutely BSL (bedside) until >3.5 mmol/l for 2 hours then 4 hourly


    Specific Management Issues

    • Early feeding is the best way to prevent rebound
    • Diabetes educator if poor understanding of diabetes management


    Discharge Criteria

    • Glucose normal and stable, tolerating oral diet & fluids
    • Adequate social supports
    • Precipitants identifi ed and treated
    • Follow up arranged


    Hospital Admission Criteria

    • Persisting low blood sugars
    • Poor social supports
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