Oral glucose

Patients with diabetes should always have immediate access to a fast-acting glucose source (see Examples of products containing approximately 15 g of glucose). This is especially important for children and adolescents with type 1 diabetes and patients using rapid-acting insulin or taking a sulfonylurea.

If a patient who is taking acarbose develops hypoglycaemia, they must take glucose to restore normal blood glucose concentration because sucrose (eg fruit juice, milk) is ineffective.

Figure 1. Examples of products containing approximately 15 g of glucose.

[NB1]

The following products in the specified quantities are a fast-acting source of approximately 15 g of glucose. They are appropriate for use in conscious and cooperative patients with nonsevere hypoglycaemia.

  • one 15 g tube of glucose gel
  • 15 g of easily absorbed carbohydrate (eg 6 to 7 regular glucose jelly beans, 4 large glucose jelly beans)
  • three teaspoons of sugar or honey
  • 125 mL of fruit juice (approximately one glass or a small popper or box)
  • 150 mL of soft drink (not ‘diet’)
  • 100 mL of oral glucose solution (eg Lucozade)
  • equivalent of 15 g in glucose tablets
Note: NB1: Check product labels for glucose (carbohydrate) content, which can vary in different commercial products.

For a conscious, cooperative child or adolescent with diabetes and nonsevere hypoglycaemia, give:

1 glucose (5 years or younger, or up to 25 kg) 5 g, orally (see Examples of products containing approximately 15 g of glucose) hypoglycaemia, nonsevere (child with diabetes)    

OR

1 glucose (6 years or older, or more than 25 kg) 10 g, orally (see Examples of products containing approximately 15 g of glucose). hypoglycaemia, nonsevere (child with diabetes)    

The blood glucose concentration takes time to rise. After 15 minutes, measure the blood glucose concentration and if it remains less than 4 mmol/L, a repeat of the glucose portion should be given.

If three or more portions of glucose are needed to restore the blood glucose concentration to normal, seek medical advice.

When the blood glucose concentration increases to normal, give a longer-acting carbohydrate (eg sandwich, dried fruit, yoghurt) to prevent recurrence of hypoglycaemia.

For a conscious, cooperative adult with diabetes and nonsevere hypoglycaemia, use:

glucose 15 g, orally (see Examples of products containing approximately 15 g of glucose). hypoglycaemia, nonsevere (adult)    

For adults with a blood glucose concentration less than 3 mmol/L, consider using a larger portion of glucose, such as approximately 20 g glucose.

If after 10 to 15 minutes the blood glucose concentration for an adult remains less than 4 mmol/L, a repeat of the glucose portion should be taken. However, it is important to also reassure patients that the blood glucose concentration takes time to rise. Providing they are alert, they should wait 10 to 15 minutes before measuring their blood glucose concentration and taking extra glucose.

If three or more portions of glucose are needed to restore the blood glucose concentration to normal, advise the patient to seek medical advice.

When the blood glucose concentration increases to normal, the patient should take a longer-acting carbohydrate (eg sandwich, dried fruit, yoghurt) to prevent recurrence of hypoglycaemia.