| Level | Glucose Threshold | Description |
|---|---|---|
| Level 1 | ≤ 70 mg/dL (3.9 mmol/L) | Glucose alert value; requires titration of therapy or carbohydrate intake. |
| Level 2 | < 54 mg/dL (3.0 mmol/L) | Clinically significant; threshold for neuroglycopenia and serious morbidity. |
| Level 3 | N/A (Variable) | Severe; characterized by altered mental/physical status requiring 3rd party help. |
Recurrent Level 2 or Level 3 events can lead to hypoglycaemia-associated autonomic failure (HAAF), where the normal catecholamine response is blunted. This "unawareness" increases the risk of fatal events. Treatment involves strict hypoglycaemia avoidance for 2-3 weeks to "reset" awareness thresholds.
6. Glycemic Targets: Standards of Care in Diabetes—2024
If the patient is unable to treat themselves due to altered consciousness or physical weakness.
Treat with 15g of fast-acting glucose (e.g., 4oz juice, 4 glucose tabs). Re-check in 15 minutes. Repeat if glucose < 70 mg/dL.