HYPOGLYCEMIA TREATMENT & PREVENTION

Hypoglycemia image drugs images

Treatment

When

Shaking, sweating, palpitation, dizziness

Verify

Test Blood glucose:  4 mmol/L or less (higher if elderly)

 

Glucose tablets

3-4 tablets (every 15 minutes after testing)

Hard candies

5-6 candies (every 15 minutes after testing)

Regular soda

120ml (every 15 minutes after testing)

Glucagon 1 mg injection (if patient unconscious)

1 injection in either arm, thigh or buttock (every 15 minutes after testing)

 

Prevention

A1C

Keep at 7% or lower (most patients

8.5% or less for patients with multiple comorbidities

Insulin

Rapid-acting insulin such as Humalog (instead of regular)

Long-acting basal insulin such as Lantus & Levemir (instead of NPH)

Sulfonylurea

Gliclazide or glimepiride (instead of glyburide)

Combo

Metformin + gliptin (Januvia)

Metformin + GLP-1 agonist (Victoza)

Metformin + pioglitazone (Actos)

(Avoid sulfonylurea + insulin)