Hypos-Don't Over Treat!

Hypoglycemia in type 1 diabetes is an emergency situation which should be treated without delay. At the same time inadvertent or over treatment of hypoglycemia leads to high blood sugar and subsequent worsening of diabetes control. Usually hypoglycemia is diagnosed when blood sugar goes below 70 mg/DL.

When it is less than 50mg/dl, it is to be corrected as quickly as possible. The aim of treatment of hypoglycemia is to bring up the glucose from <70mg to around 100mg. This can be done quickly with use of glucose powder. Those dose of glucose to be used depends in the age of child. Children less than 5 yes of age requires around 5gm of glucose, children between 5and 10 years of age requires 10gm of glucose, and children above 10 years of age requires 15 gm glucose for correction of hypoglycemia.

One teaspoon of glucose powder contain 5gm of glucose and one tablespoon contain 15 gm of glucose. Glucose tablet containing 5 gm of glucose are also available in the market (eg.glucovita) Once glucose is given check the blood glucose level 15 min later and that blood glucose should have come more than 70 mg/DL. If not corrected then give same amount of glucose once more. This is called the rule of 15. That is, give 15 gm glucose, recheck blood glucose 15 minutes later and if not corrected give another 15gm glucose. 15gm of glucose is present in 4 no's of orange and fruit juice or in one.  Candy, chocolate or ice cream should not be given for correcting hypoglycemia.

Since it contains a lot of fat which will slow down the absorption of glucose from chocolate or ice cream. After treating hypoglycemia with glucose such as take bread and jam, if there is no major meal in the next one hour, a slowly digesting carbohydrate containg 15 gm of glucose can be given. Giving large amount of glucose instead of the recommended 5-15 gmglucose will lead to blood sugar going to 300-400 range and then will need extra insulin to bring it down. So, never over treat hypoglycemia.