HYPOGLYCEMIA TREATMENT & PREVENTION
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Treatment |
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When |
Shaking, sweating, palpitation, dizziness |
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Verify |
Test Blood glucose: 4 mmol/L or less (higher if elderly) |
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Glucose tablets |
3-4 tablets (every 15 minutes after testing) |
|
Hard candies |
5-6 candies (every 15 minutes after testing) |
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Regular soda |
120ml (every 15 minutes after testing) |
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Glucagon 1 mg injection (if patient unconscious) |
1 injection in either arm, thigh or buttock (every 15 minutes after testing) |
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Prevention |
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A1C |
Keep at 7% or lower (most patients 8.5% or less for patients with multiple comorbidities |
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Insulin |
Rapid-acting insulin such as Humalog (instead of regular) Long-acting basal insulin such as Lantus & Levemir (instead of NPH) |
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Sulfonylurea |
Gliclazide or glimepiride (instead of glyburide) |
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Combo |
Metformin + gliptin (Januvia) Metformin + GLP-1 agonist (Victoza) Metformin + pioglitazone (Actos) (Avoid sulfonylurea + insulin) |