Weight‐based hypoglycaemia treatment protocol for adults with Type 1 diabetes: a randomized crossover clinical trial

Abstract

A weight-based protocol of 0.3 g/kg glucose appears more effective for treating symptomatic hypoglycaemia in adults with Type 1 diabetes than either the most common current recommendation of 15 g glucose or a 0.2 g/kg glucose dose.

Weight‐based carbohydrate treatment of hypoglycaemia in people with Type 1 diabetes using insulin pump therapy: a randomized crossover clinical trial

“…The clinically important difference we wished to detect between the active and usual treatment arm was 0.5 mmol/l. This is similar in size to the effect we observed in our previous research . The standard error of the difference we observed in this previous research was 0.17 mmol/l.…”

“…The present study shows that in children and adults with Type 1 diabetes who are using CSII for diabetes management, initial treatment of hypoglycaemia with a weight‐based glucose dose, adjusted to initial blood glucose level, is more effective than a standard dose protocol in resolving the hypoglycaemia and does not result in greater rebound hyperglycaemia. This extends the findings of our previous research comparing these protocols in children and adults using multiple daily injections for Type 1 diabetes .…”

“…In our two previous hypoglycaemia studies, we demonstrated a mean capillary glucose response of 1.5 mmol/l in adults at 10 min and a median of 1.2 mmol/l in children while using a weight‐based protocol . Together, the results of these three studies suggest that people with Type 1 diabetes should increase the treatment quantities of glucose if the initial capillary glucose measurement is <3.0 mmol/l.…”

Dietary sugars versus glucose tablets for first-aid treatment of symptomatic hypoglycaemia in awake patients with diabetes: a systematic review and meta-analysis

“…Although glucose tablets and dietary sugars may be viable treatment options, few studies have examined the most appropriate dose of carbohydrates. While a 15 g tablet is commonly advocated, 20 g tablets or even a weight-based approach, such as 0.3 g/kg, may be more effective in treating hypoglycaemia 14 15…”

Type 1 diabetes in adults: supporting self management

“…47 The commonest recommendation for self treatment of biochemical or symptomatic hypoglycaemia is 15 g of fast acting carbohydrate (such as dextrose tablets, a sugary drink, or, in the UK, Bassett's Jelly Babies (as they are almost exactly 5 g of carbohydrate per "baby")). 7 However, a recent randomised controlled crossover study suggested that weight based treatment of hypoglycaemia using 0.3 g/kg glucose is more effective in resolving hypoglycaemia than a standard 15 g. 48 For personal use only: See rights and reprints http://www.bmj.com/permissions Subscribe: http://www.bmj.com/subscribe…”