A hypoglycemia treatment kit should be readily available (containing ready sources of glucose).

The risk associated with hypoglycemia and frailty is considerable. The diabetes guidelines aim to minimize hypoglycemic episodes. However, when hypoglycemia occurs, adjust treatment accordingly:

• If blood glucose < 3.9 mmol/L:
  • Give oral carbohydrate (CHO), such as 15 ml (one tablespoon) of sugar in water, ¾ cup juice or regular soft drink, or 15g glucose in the form of glucose tablets.
  • Recheck BG in 15 minute intervals until BG is >4.0 mmol/L.
  • If meal is more than 30 minutes away, give snack containing CHO and protein such as bread and cheese or meat.
• If resident is unable to ingest or unconscious:
  • Give 1 mg glucagon, intramuscularly (write prn order in advance).
  • Notify the physician or nurse practitioner.

For a full version of this guideline (Phase 1 and 2), go to:

http://diabetescare.nshealth.ca/guidelinesresources/professionals/guidelines/special-populations