Hypoglycemia may occur as a result of an excess of insulin relative to food intake, energy expenditure or both. Mild episodes of hypoglycemia 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 hypoglycemia will coma, seizure, or neurologic impairment may be treated with intramuscular/subcutaneous glucagons or concentrated intravenous glucose. Glucose must also be given intravenously. If the patients does not respond to glucagons within 10 to 15 minutes, sustained carbohydrates intake and observation may be necessary because hypoglycemia may recur after apparent clinical recovery.
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