Uganda guidelines for the treatment of Hypoglycaemia
Uganda Clinical Guidelines 2023 · all from source →
General Adult
Diagnosis
Definition
Blood glucose <3.0 mmol/L (55 mg/dl).
Early Symptoms
Hunger, dizziness, tremors, sweating, nervousness, confusion, palpitations, weakness.
Late / Severe Features
Profuse sweating, convulsions, loss of consciousness.
Investigations
Blood glucose (generally <3.0 mmol/L). Specific investigations to exclude other causes (insulin overdose, alcohol, hepatic disease, insulinoma, etc.).
Treatment
Patient Able to Swallow (Conscious)
Oral glucose or sugar 10–20 g in 100–200 ml water (2–4 teaspoons). Repeat after 15 minutes if necessary.
Patient Unconscious — Adults
Glucose 50% IV: 20–50 ml slowly (3 ml/minute) or diluted with normal saline. Follow with Dextrose 10% by drip at 5–10 mg/kg/minute until consciousness is regained. Then encourage oral snacks.
Patient Unconscious — Children
Dextrose 10% IV: 2–5 ml/kg.
No Recovery After 30 Minutes
If patient does not regain consciousness after 30 minutes, consider other causes of coma and investigate accordingly.
Monitoring
Monitor blood sugar for several hours (at least 12 hours if hypoglycaemia caused by oral antidiabetics). Investigate and manage the underlying cause.
Note — IV Line Care
After Dextrose 50%, flush IV line immediately to avoid vein sclerosis (dextrose is highly irritant). Do not store prepared Dextrose 10% solutions.
Prevention — Patient Education
Educate patients at risk (diabetics, post-gastrectomy patients) on recognition of early hypoglycaemia symptoms. Advise regular meals and always having glucose or sugar available for emergency treatment. Advise diabetic patients to carry an identification tag.
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