When the Blood Glucose Level (BGL) falls below that required for optimal physiological function, (usually < 4mmol/L) with demonstrable signs or symptoms.
Clinical Presentation
Weakness, trembling, shaking.
Diaphoresis.
Headache.
Abnormal behaviour.
Altered conscious state.
Tachycardia.
Seizure
Exclusion Criteria
Exclusion Criteria
Risk Assessment
Always treat diabetics with altered conscious state as having hypoglycaemia, as well as any other problems (extra glucose won't worsen the hyperglycaemia, and saves the life of the unconscious hypoglycaemic).
Diabetic patients taking Glucobay (Acarbose) have a greater glucose requirement due to stimulation of pancreatic insulin release.
Consider the aetiology of hypoglycaemia when selecting the most appropriate treatment (eg: glucagon will be ineffective in the absence of adequate hepatic glycogen stores).
Chronic poorly controlled diabetes may be hypoglycaemic despite a BGL >4mmol/L.
Encourage transport post treatment.
Hypoglycaemia may present as a focal neurological deficit or coma.
All patients with an altered GCS (i.e. abnormal for the individual) should have a BGL test preformed and managed appropriately if symptomatic.
IV boluses of glucose may need to be repeated when the patient remains hypoglycaemic due to an Insulin overdose (accidental/intentional), the objective is to achieve normoglycaemia, GCS may not improve.
Hypoglycaemia may present as a focal neurological deficit or coma.
Encourage transport post treatment.
Where intentional overdose is suspected the patient should be transferred to a healthcare facility, seek WAPOL support if required.