MEDICAL MANAGEMENT: prevent recurrence of

hypoglycemia
A. IMMEDIATE TREATMENT: 2. Some patients experience
 The usual recommendation is for 15 g of a fast- nausea after the
acting concentrated source of carbohydrate such administration of glucagon; if
as the following, given orally: this occurs, the patient should
o Three or four commercially prepared be turned to the side to
glucose tablets prevent aspiration.
o 4 to 6 oz of fruit juice or regular soda  D50W
o 6 to 10 Life Savers or other hard o In the hospital or emergency
candies department, patients who are
o 2 to 3 teaspoons of sugar or honey unconscious or cannot swallow
 Avoid having anything with chocolate, nuts, or may be treated with 25 to 50 mL
high fat dairy (eg. whole milk and cheese) 50% dextrose in water (D50W)
because fat and proteins can slow the digestion of administered intravenously.
carbs into sugar as a result blood sugar won't rise o Nx Consideration:
fast enough (it can take 15 mins for 1. Thick solution so, patients
carbohydrates to rise sugar) may complain of a headache
 The blood glucose level should be retested in 15 and of pain at the injection
minutes and retreated if it is less than 70 to 75 site.
mg/dL (3.8 to 4 mmol/L). a. Assuring patency
 If the symptoms persist more than 10 to 15 of the intravenous
minutes after initial treatment, the treatment is (IV) line used
repeated even if blood glucose testing is not because hypertonic
possible. solutions such as
 Once the symptoms resolve, a snack containing 50% dextrose are
protein and starch (eg, milk or cheese and very irritating to the
crackers) is recommended unless the patient vein
plans to eat a regular meal or snack within 30 to 2. The effect is usually seen
60 minutes. within minutes
a. strictly monitor
B. PHARMACOLOGICAL MANAGEMENT blood sugar
C. SURGICAL MANAGEMENT
EMERGENCY MEASURES:  If the hypoglycemia is occurring due to an
underlying condition such as pancreatic
 Glucagon
tumor, then surgery may be necessary to
o Glucagon is a hormone that breaks
remove the tumor or even part of the
down stored glucose, so glucose pancreas.
can enter bloodstream and rise
blood sugar up PATIENT TEACHING
o For patients who are unconscious
and cannot swallow, an injection 1. To carry some form of simple sugar and glucagon
of glucagon 1 mg can be kit with them at all times.
administered either 2. To refrain from eating high-calorie, high fat
dessert foods to treat hypoglycemia. The high fat
subcutaneously or intramuscularly.
content of these foods may slow the absorption of
Injectable glucagon is packaged as
the glucose, and the hypoglycemic symptoms
a powder in 1-mg vials and must
may not resolve as quickly as they would with the
be mixed with a diluent before
intake of carbohydrates.
being injected.
3. Teach the patient/family the signs of
o After injection of glucagon, it may
hypoglycemia, and to identify cause of
take up to 20 minutes for the
insulin shock to prevent in the future
patient to regain consciousness
4. Hypoglycemia is prevented by a consistent
o Nx Consideration:
pattern of eating, administering insulin, and
1. A concentrated source of exercising
carbohydrate followed by a 5. Because unexpected hypoglycemia may occur, all
snack should be given to the patients treated with insulin should wear an
patient on awakening to
 identification bracelet or tag stating that they
have diabetes
6. Teach the patient/family which
foods/beverages to use in cases of
hypoglycemia and the carbohydrate counts
of each.
7. Family should be taught to encourage and even
insist that the (resistant) person with diabetes
assess blood glucose levels if hypoglycemia is
suspected.
8. Patients taking beta blockers may not show
outward signs of hypoglycemia. It is very
important for these patients to perform blood
glucose tests on a frequent and regular basis.
9. Sometimes patient can experience hypoglycemic
unawareness (condition where the body doesn’t
give any warning signs that the blood sugar is
getting low) can cause severe/ life threatening
low blood sugar
a. patient should perform blood glucose
tests on a frequent and regular basis.