Hypoglycemia Response
EmergenciesThe steps
- Symptoms (shaky, sweaty, confused, irritable) → check the glucose NOW; treat first and investigate later if meter unavailable and patient symptomatic
- Awake and can swallow: 15–20 g fast carbs (4 oz juice, glucose tabs) — NOT peanut butter/milk first (fat slows absorption)
- Recheck in 15 minutes. Still < 70? Repeat. (The 15-15 rule)
- Can't swallow / unresponsive: IV D50 per protocol, or glucagon IM if no access
- Once recovered: complex carb + protein snack to hold the level
- Document: value, treatment, recheck value, and WHY it happened
🛡 Never skip
Find the cause before you chart 'resolved': NPO with insulin given? Peak-time miss? Wrong dose? The next low is preventable Sulfonylurea lows (glipizide, glyburide) RECUR for hours — one juice is not a fix; keep watching Beta blockers mask the warning signs — the confused diabetic on metoprolol may never feel shaky
Common mistakes
- Treating and not rechecking at 15 minutes
- Over-treating: a whole tray of juice + cookies = rebound hyperglycemia
- Not flagging the insulin/food mismatch that caused it
Source: ADA Standards of Care; Lippincott Nursing Procedures, 9th ed.Reference only — verify against your facility's policy.
