Episode 23: Treating Symptoms of Hypoglycemia

(Baonghean) - Hypoglycemia, if not treated promptly, can lead to serious consequences; therefore, it is crucial to take it seriously and take timely action depending on the specific situation.

1. The patient is still conscious:

- Drink sugary beverages until your symptoms improve.

- Do not consume artificial sweeteners (sodium saccharinate, ammonium saccharineate) intended for people with diabetes.

2. The patient is in a coma:

Emergency treatment.

2.1. 30% or 50% Glucose solution.

Intravenous glucose infusion is administered as follows: Glucose Amount = [Weight (kg) x 0.2] x [Gbt - Gh]. Where Gbt is the target plasma glucose concentration (e.g., G = 1 g/l), and Gh is the blood glucose concentration during hypoglycemia (e.g., Gh = 0.2 g/l). Thus, for a patient weighing 50 kg, the initial glucose infusion is: 50 x 0.2 x (1 x 0.2) g = 8 g glucose.

Infusion should not be done via drip; instead, it must be administered directly into the vein to achieve a rapid and high increase in blood glucose concentration.

2.2. Glucagon (1 mg ampoule):

Glucagon is administered intravenously, intramuscularly, or subcutaneously at a dose of 1-2 mg, which can be repeated after 10-20 minutes (short half-life). It should not be used in patients with severe alcoholism due to poor hepatic glycogen reserves, or in patients who have fasted for a long time and have no remaining hepatic glycogen reserves. Patients with long-standing type 1 diabetes also respond poorly to glucagon.

2.3. Hydrocortisone: 100mg intravenous injection.

Dr. Nguyen Van Hoan (Director of Nghe An Endocrinology Hospital)