Management of hypoglycaemia in hospital
The Scottish Short Life Working Group (SLWG) for diabetes in inpatients was asked to review the suitability of the NHS diabetes guideline “The Hospital Management of Hypoglycaemia in Adults with Diabetes Mellitus” (www.diabetes.nhs.uk) for use in Scotland. We would support the use of this document, though have modified the management algorithm (Figure 1) to include more detail and added an SBAR (situation, background, assessment, recommendation) chart (Figure 2) that we hope will be used in conjunction with the algorithm.
The specific treatments are suggestions and will need approval from individual MCNs; it may be that some areas will favour one treatment option over others, and the document may be modified accordingly. In particular, we do not favour the use of 50% glucose given the risks associated with extravasation; however we felt that there may be variable availability of 10% and 20% glucose and so the option of 50% glucose could not be omitted unless local stocks provided alternatives.
We would also suggest that safe and effective management of hypoglycaemia in hospitals is facilitated by the use of “hypo” boxes maintained within each ward. A suggestion for the contents of the box is contained within the NHS Diabetes guideline.
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