🍬 Hypoglycemia Management
This tool guides hypoglycemia treatment by consciousness/swallowing status and IV access, applying the 15-15 rule for awake patients and glucagon or IV glucose for severe cases.
Patients with impaired consciousness must not be fed food or liquids because of aspiration risk — use IV dextrose or glucagon instead. (original synthesis · not guideline verbatim)
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When to use
Use at the bedside to choose route and agent: oral fast-acting carbohydrate when awake and swallowing, IV dextrose when access exists, and glucagon when it does not.
How it works
Awake/swallowing → 15 g fast carbohydrate, recheck at 15 min, repeat until > 70 mg/dL, then a protein-containing meal. Impaired → no oral intake; IV access → 25 mL D50; no access → glucagon 1 mg IM/SC (or 3 mg nasal).
Key points
- Patients with impaired consciousness must not be fed food or liquids because of aspiration risk — use IV dextrose or glucagon instead. (original synthesis · not guideline verbatim)
- After recovery, a small meal with protein and complex carbohydrate prevents rebound hypoglycemia, and precipitants should be corrected.
- Hypoglycemia tends to recur, so monitoring is intensified and the glucose-lowering regimen reviewed.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Consciousness/swallowing status | Awake, able to swallow |
|---|---|
| IV access (when unable to swallow) | Has IV access |
→Disposition15-15 rule oral carbohydrate
- Oral fast-acting carbohydrate：Awake and able to swallow: 15 g fast-acting carbohydrate (glucose tablets, ~120 mL juice, regular sugary cola), recheck fingerstick glucose after 15 min
- Repeat：Still < 70 mg/dL (3.9 mmol/L) → another 15 g, wait another 15 min, repeat until glucose recovers (inpatient target > 80 mg/dL)
- Consolidate：After recovery, eat a small meal with protein + complex carbohydrate to prevent recurrence
| Consciousness/swallowing status | Impaired consciousness/coma/unable to swallow |
|---|---|
| IV access (when unable to swallow) | No IV access |
→DispositionGlucagon IM/SC
- No oral intake (aspiration risk)：Impaired consciousness/coma/unable to swallow: do not feed food or liquids (aspiration risk)
- With IV access：If IV access can be established: 25 mL of 50% glucose IV push
- No IV access：Glucagon 1 mg IM/SC (or 3 mg nasal spray); may repeat once if not recovered in 15 min; call emergency services
Frequently asked questions
- What is Hypoglycemia Management?
- This tool guides hypoglycemia treatment by consciousness/swallowing status and IV access, applying the 15-15 rule for awake patients and glucagon or IV glucose for severe cases.
- How is Hypoglycemia Management calculated? What is the core formula?
- Awake/swallowing → 15 g fast carbohydrate, recheck at 15 min, repeat until > 70 mg/dL, then a protein-containing meal. Impaired → no oral intake; IV access → 25 mL D50; no access → glucagon 1 mg IM/SC (or 3 mg nasal).
- When is Hypoglycemia Management used?
- Use at the bedside to choose route and agent: oral fast-acting carbohydrate when awake and swallowing, IV dextrose when access exists, and glucagon when it does not.
- What are the key clinical points for Hypoglycemia Management?
- Patients with impaired consciousness must not be fed food or liquids because of aspiration risk — use IV dextrose or glucagon instead. (original synthesis · not guideline verbatim) After recovery, a small meal with protein and complex carbohydrate prevents rebound hypoglycemia, and precipitants should be corrected. Hypoglycemia tends to recur, so monitoring is intensified and the glucose-lowering regimen reviewed.
- What are the limits and cautions when using Hypoglycemia Management?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Hypoglycemia Management calculated in practice? Can you show a worked example?
- Inputs: Consciousness/swallowing status Awake, able to swallow, IV access (when unable to swallow) Has IV access → Result: Disposition 15-15 rule oral carbohydrate（Oral fast-acting carbohydrate: Awake and able to swallow: 15 g fast-acting carbohydrate (glucose tablets, ~120 mL juice, regular sugary cola), recheck fingerstick glucose after 15 min, Repeat: Still < 70 mg/dL (3.9 mmol/L) → another 15 g, wait another 15 min, repeat until glucose recovers (inpatient target > 80 mg/dL), Consolidate: After recovery, eat a small meal with protein + complex carbohydrate to prevent recurrence） Inputs: Consciousness/swallowing status Impaired consciousness/coma/unable to swallow, IV access (when unable to swallow) No IV access → Result: Disposition Glucagon IM/SC（No oral intake (aspiration risk): Impaired consciousness/coma/unable to swallow: do not feed food or liquids (aspiration risk), With IV access: If IV access can be established: 25 mL of 50% glucose IV push, No IV access: Glucagon 1 mg IM/SC (or 3 mg nasal spray); may repeat once if not recovered in 15 min; call emergency services）