Change to treatment of hypoglycaemia needed, NZ researchers say

Clinical nurse specialist diabetes Lindsay McTavish is among the researchers who have found a better way to treat hypoglycaemia. Photo / Supplied

Standard practise for treating low blood sugar levels is not the best approach, new research has found.

Current international guidelines are to give children 10g of glucose, and adults 15g if they are hypoglycaemic but research from Capital & Coast DHB and the University of Otago found that was not the best treatment method.

Symptoms of hypoglycaemia include fatigue, dizziness, blurred vision and confusion, but can be resolved within 10-12 minutes if treated correctly and quickly.

Clinical nurse specialist for diabetes Lindsay McTavish said the guidelines were based on expert opinion rather than practical first-hand experience. So, she and doctors Brian Corley, Mark Weatherall, Esko Wiltshire and Jeremy Krebs carried out trials to determine if the dosee should vary with the patient's weight.

"We carried out four clinical trials over 10 years to try to find whether there is a faster and more effective way to treat hypoglycaemia in children and adults with diabetes," McTavish said.

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And there was.

Results published last month showed larger people needed more glucose so a weight-based method was the best way of managing hypoglycaemia. Capital & Coast and Hutt Valley DHBs switched to a weight-based approach 10 years ago for children and five years ago for adults.

"The evidence is clear for type 1 diabetes, and there is a subtle difference for type 2," McTavish said.

"The weight-based protocol is better than the standard dose recommended internationally, but is similar to a bigger fixed dose of 30g of glucose used on CCDHB wards.

"We've demonstrated that larger people need more glucose to overcome hypoglycaemic events – in contrast to the international guidelines that don't take a patient's size into account.

"If reviewed and adopted, these studies could change how hypoglycaemia is treated and managed internationally – giving doctors and patients clearer direction about how to resolve symptoms faster."