Management of Hypoglycaemia

By ULY CLINIC staff

Diagnosis of Hypoglycemia is made when

Random Blood glucose (RBG) is < 2.5mmol/L (45mg/dl) in normal nourished children OR
<3mmol/L (54mg/dl) in malnourished children THEN

Give Dextrose 10% IV 5ml/Kg as a BOLUS

Re check the blood glucose level after 30minutes if still low repeat 5ml/kg 10% Dextrose IV

Feed the child as soon as he/she is conscious

If the child is able to feed without danger of aspiration give

Milk or sugar solution via a nasogastric tube (to make sugar solution dissolve 4 tea level spoon of sugar (20g) in a 200ml cup of clean water) OR
IV fluids containing 5 – 10 % dextrose

To make sugar solution, dissolve 4 level teaspoons of sugar (20 grams) in a 200-ml cup of clean water.

Note: 50% glucose solution is the same as 50% dextrose solution or D50. If only 50% glucose solution is available: dilute 1 part 50% glucose solution to 4 parts sterile water, or dilute 1 part 50% glucose solution to 9 parts 5% glucose solution.

Note: For reliable results, take great care with the dextrostix test. The strip must be stored in its box, at 2-3 °C, avoiding sunlight or high humidity. A drop of blood should be placed on the strip (it is necessary to cover all the reagent area). After 60 seconds, the blood should be washed off gently with drops of cold water and the color compared with the key on the bottle or on the blood glucose reader. (The exact procedure will vary with different strips.)

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Updated on 21.08.2020

References

WHO.https://www.who.int/elena/titles/full_recommendations/sam_management/en/index5.html. August 21.2020
Tanzania Standard treatment guidline for pediatric, edition 2017