Hypoglycaemia (low blood glucose)

Summary of changes

Addition

  • Medical emergency if BGL less than 4mmol/L (previously different measurements used if under or over 10 years old)
  • Change to BGL less than 4mmol/L for everyone (all age)

Other

  • Glucose administrated before thiamine (previously visa versa). Glucose administration should not be delayed pending administration of thiamine, which should be given as soon as possible
  • Addition of the rule of 15:15 rule: give 15g of carbohydrates, check BGL in 15 minutes and give another 15g of carbohydrates if BGL still low

Primary references

  1. Abraham MB, Jones TW, Naranjo D, Karges B, Oduwole A, Tauschmann M and Maahs DM (2018) 'ISPAD Clinical Practice Consensus Guidelines 2018: Assessment and management of hypoglycemia in children and adolescents with diabetes', Pediatric Diabetes, 19(Suppl 27):178-192, doi:10.1111/pedi.12698

  2. Australian and New Zealand Committee on Resuscitation (2021) ANZCOR Guideline 9.2.9 – First aid Management of a Diabetic Emergency, The ARC Guidelines, accessed 3 October 2022.

  3. National Institute for Health and Care Excellence (2016) Diabetes in adults [QS6], NICE Clinical Guidelines, accessed 3 October 2022.

  4. Royal Australian College of General Practitioners (2020) Management of type 2 diabetes: A handbook for general practice, RACGP, East Melbourne, Vic, accessed 3 October 2022.

  5. Schabelman E and Kuo D (2012) 'Glucose before thiamine for Wernicke encephalopathy: a literature review', Journal of Emergency Medicine, 42(4):488-94, doi:10.1016/j.jemermed.2011.05.076

  6. The Royal Children's Hospital Melbourne (2019) Hypoglycaemia, Clinical Practice Guidelines, accessed 11 January 2022.

  7. Vella A (2021) Hypoglycemia in adults without diabetes mellitus: Clinical manifestations, diagnosis, and causes, UpToDate, accessed 11 January 2022.