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Management of hypoglycaemia in a child

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Consult expert advice:

  • establish the diagnosis with an immediate finger prick glucose test

Glucose 10-20 g is given by mouth either in liquid form, eg milk 200 mL, or as granulated sugar (2 teaspoons) or sugar lumps

  • if necessary, this may be repeated following 10-15 minutes
  • further food is required to prevent recurrence of hypoglycaemia.

Hypoglycaemia which causes unconsciousness or fitting is an emergency

  • if sugar cannot be given by mouth, glucagon can be given by injection
    • a child aged under 8 years or of bodyweight under 25 kg should be given 500 micrograms
  • in order to restor liver function then carbohydrates should be given as soon as possible
  • glucagon may be issued to parents or carers of insulin-treated children for emergency use in hypoglycaemic attacks
    • it is often advisable to prescribe on an 'if necessary' basis to hospitalised insulin-treated children, so that it may be given rapidly by the nurses during a hypoglycaemic emergency
    • if not effective in 10 minutes, IV glucose should be given.

Alternatively, 2-5 mL/kg of glucose IV infusion 10% (200-500 mg/kg of glucose) may be given IV into a large vein, through a large-gauge needle

  • this concentration is irritant, especially if extravasation occurs
  • glucose IV infusion 50% is not recommended, as it is very viscous and hypertonic.
  • patient should be monitored closely, particularly in the case of an overdose with a long-acting insulin because further administration of glucose may be required.

Neonatal hypoglycaemia

  • treated with glucose IV infusion 10% given at a rate of 5 mL/kg/hour
    • initial dose of 2.5 mL/kg over five minutes may be required if hypoglycaemia is severe enough to cause loss of consciousness, or fitting
  • miild asymptomatic persistent hypoglycaemia may respond to a single dose of glucagon
    • dose is 20 mcg per kg
  • glucagon has also been used in the short-term management of endogenous hyperinsulinism.

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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