UCSD MC HYPOGLYCEMIA PROTOCOL
Definition: Blood Glucose (BG) < 70 mg/dl with OR without symptoms
OR Glucose < 80 mg/dl with symptoms (ex. shakiness, diaphoresis, confusion, irritability)
1. TREATMENT: * If on IV insulin infusion, stop infusion, recheck blood glucose q15min
until
BG ≥80 mg/dL 2 times in a row, then resume insulin infusion per computer protocol.
CONSCIOUS, ABLE TO
SWALLOW, ABLE TO TAKE PO:
UNCONSCIOUS, UNABLE TO
SWALLOW, UNABLE TO TAKE PO:
Give fast-acting carbohydrate.
With IV:
o Give 25 ml (12.5 grams) of D50 IV over
5 minutes
Choose ONE of the following:
o
o
o
o
4 Glucose tablets (16 grams)OR
4 oz juice OR
8 oz skim milk OR
1 tube Glucose Gel
No IV access:
o Give 1 mg Glucagon IM (turn pt on side,
may induce emesis) – Do not repeat
Glucagon.
o OR Start IV stat and give 25 ml (12.5
grams) D50 over 5 minutes
2. RETEST:
-Retest blood glucose within 15-30 minutes from initial Glucose test.
-If Repeat BG is < 80, repeat treatment and check BG again within 30 minutes.
-Continue to check BG q15-30min until BG > 80 mg/dl, 2 times in a row.
-Document treatment and repeat glucose values.
3. ASSESS possible cause of hypoglycemia to avoid recurrence. Most common causes of hypoglycemia
are interruption of food, tube feedings or IV dextrose, and decreased steroids not matched with
decrease in insulin. Does patient need Medicine or Endocrine consult for recurring hypoglycemia?
Need to stop oral agent or reduce insulin?
4. NOTIFY MD of hypoglycemic event, use SBAR (include vitals, symptoms, time of last nutritional
intake, time/dose of glucose lowering agents, response to therapy) and ask for change in regimen if
appropriate.
5. DOCUMENT event, times of glucose checks, signs and symptoms, treatment, resolution,
assessment, correspondence with MD and changes in therapy:
Example: 11:00 am: Pt shaky and diaphoretic. BG=46
11:03 am: Pt given 4 glucose tablets.
11:25 am: BG=74. Pt given 8 oz milk. Lunch served.
11:55 am: BG=128.
12:20 pm: BG=169. Pt denies complaints. States he feels “fine.”
12:40 pm: Dr. Smith notified of pt’s hypoglycemia, tx and current status.
Insulin doses changed per md.
D1560 (5-13)