Hypoglycaemia may occur as a result of an excess of insulin relative to food intake, energy expenditure or both. Mild episodes of hypoglycaemia usually can be treated with oral glucose. It is therefore recommended that the diabetic patient constantly carry some sugar lump, sweets, biscuits or sugary fruit juice. Adjustments in drug dosage, meal patterns, or exercise may be needed. More severe episodes of hypoglycaemia with coma, seizure, or neurologic impairment may be treatment with intravascular/subcutaneous glucagon or concentrated intravenous glucose. Glucose must also be given intravenously. If the patient does not respond to glucagon within 10 to 15 minutes, sustained carbohydrates intake and observation may be necessary because hypoglycaemia may recur after apparent clinical recovery.
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