To avoid potential hypoglycaemia, Diabetes UK recommends a practical policy of "make four the floor", i.e. 4.0mmol/l, the lowest acceptable blood glucose level in people with diabetes. Regular blood glucose monitoring enables detection of asymptomatic biochemical hypoglycaemia.
Initially, glucose 10-20g is given by mouth either as a glucose gel or as granulated sugar (2 teaspoons) or 3 sugar lumps. This can be repeated in 10-15 minutes if necessary. After initial treatment, a snack providing sustained availability of carbohydrate or the next meal can stop blood glucose falling again.
Hypoglycaemia which causes unconsciousness is an emergency and glucagon should be given by injection if sugar cannot be given orally.
There are "Hypo Boxes" available on all wards which contain:
- Glucagon kit
- Glucotabs
- GlucoGel
- 10% IV glucose 500ml
- 20% IV glucose 500ml