Summary Of Critical Appraisal
Detailed summaries regarding the strengths and limitations of the included SRs, RCT, NRS, economic evaluation, and evidence-based guidelines are provided in : , ,, and .
Systematic Reviews
Both SRs, were conducted according to standard methodology and reporting requirements for Cochrane reviews. An a priori design was described, comprehensive literature searches of 4 to 5 databases were conducted, types of studies, selection criteria, participants, interventions, and primary and secondary outcomes for the reviews were identified. Lists and characteristics of included studies were provided. Excluded studies were identified but comprised only one study in one SR and none in the other SR. One SR included a single RCT that was judged to have low risk of bias and the evidence was assessed as ranging from high to moderate quality using the GRADE method. Caution was advised in interpreting some of the data due to low event rates . The majority of included infants in the RCT were born to a birthing parent with diabetes which might affect the generalizability of the findings to other patient populations with different risk factors. The other SR included two RCTs, for which one RCT was assessed to have low risk of bias and the other RCT, which was only available in abstract form, to have insufficient detail to determine risk of bias, although some unexplained attrition was considered likely.
Randomized Controlled Trial
Non-Randomized Studies
Economic Evaluation
Guidelines
How Can I Prevent Low Blood Glucose
Your best bet is to practice good diabetes management and learn to detect hypoglycemia so you can treat it earlybefore it gets worse.
Monitoring blood glucose, with either a meter or a CGM, is the tried and true method for preventing hypoglycemia. Studies consistently show that the more a person checks blood glucose, the lower his or her risk of hypoglycemia. This is because you can see when blood glucose levels are dropping and can treat it before it gets too low.
If you can, check often!
- Check before and after meals.
- Check before and after exercise .
- Check before bed.
- After intense exercise, also check in the middle of the night.
- Check more if things around you change such as, a new insulin routine, a different work schedule, an increase in physical activity, or travel across time zones.
A Low Blood Sugar Level And Driving
You may still be allowed to drive if you have diabetes or you’re at risk of a low blood sugar level for another reason, but you’ll need to do things to reduce the chance of this happening while you’re driving.
You also need to tell the Driver and Vehicle Licensing Agency and your car insurance company about your condition.
For more information, see:
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What To Do When Your Blood Sugar Drops
Well, one of the best ways is to eat to get blood sugar up. If you are suffering from diabetes and you think that you have hypoglycemia, it is important to check your blood sugar levels. If you feel that the blood sugar levels drop after you eat a meal, you need to change the diet you are following. You need to avoid taking any foods that are high in sugar content and stick to eating small meals during the day.
If you are having low blood sugar levels even when you havent eaten anything, you can try having a snack before hitting the bed. You can eat a snack that is rich in protein or complex carbohydrate.
In case the doctor finds out that too much if insulin is causing trouble, he/she might as well reduce the dose and observe the levels. Do follow the below mentioned routine when you have low blood sugar levels.
Test The Sugar Levels Well, this goes without saying. But, remember that the value less than 70 milligrams per deciliter means you have low blood sugar.
Try To Eat or Even Drink Some Fast Acting Carbs When you are suffering from low blood sugar, you certainly need to act quickly. You need to consume at least 15 gms of carbs. You can try taking about 4 ounces of juice or just have a tablespoon of sugar with water.
Glucose Tablets or Gel You can as well take glucose tablets or opt for the glucose gel. Medical experts say that people who take medications for diabetes need to carry glucose tablets with them for sure.
Medically Reviewed By
How To Treat Someone Who’s Unconscious Or Very Sleepy
Follow these steps:
They may need to go to hospital if they’re being sick , or their blood sugar level drops again.
Tell your diabetes care team if you ever have a severe hypo that caused you to lose consciousness.
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Review Of Top 7 Fast Acting Dextrose Gels
Modified: Jun 3, 2020 by Bridget Montgomery · This post may contain affiliate links ·
Hypoglycemia, or low blood sugar, happens when blood glucose levels drop below their normal range. This can occur very fast and catch you off guard. Symptoms of mild hypoglycemia include: dizziness, sweating, hunger, confusion, anxiety, and weakness. A blood sugar level below 70 mg/dL is considered low, or hypoglycemia.
Most of the time hypoglycemia is mild and can be easily treated with an edible dose of dextrose. Dextrose is chemically identical to glucose and is made from corn. Its always important to be prepared by carrying dextrose at all times.
If you do not have dextrose on you, hypoglycemia can progress into more severe symptoms like seizures and even a coma. Diabetics should never skip meals because this could lead to a drop in blood glucose. Also, injecting too much insulin can cause hypoglycemia. Some other causes of low blood sugar are exercising or too much activity and drinking alcohol.
If youre having an episode of low blood sugar, you should supplement with a dextrose product to raise blood glucose levels quickly. Always alert family and friends as to where you keep your dextrose in case they need to get it for you in an emergency.
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How Long Do Glucose Gels Work To Raise Low Blood Sugar Levels
It varies depending on how severe the low blood sugar episode is. Glucose gels are one way to help get your blood sugar levels back to normal and provide energy for your cells again!
Most glucose tablets and gels come in a precise dose of 15 grams of sugar. The standard recommended amount of glucose to raise your low blood sugar is 15 grams.
In general, four glucose tablets or 1 pure glucose gel of 15 grams should be enough to get your blood sugar back on track. You should check your blood sugar level after taking these pills for 15 minutes.
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Symptoms Of A Low Blood Sugar Level
A low blood sugar level can affect everyone differently. You’ll learn how it makes you feel, although your symptoms may change over time.
Early signs of a low blood sugar level include:
- a fast or pounding heartbeat
- becoming easily irritated, tearful, anxious or moody
If a low blood sugar level is not treated, you may get other symptoms, such as:
- unusual behaviour, slurred speech or clumsiness
- seizures or fits
- collapsing or passing out
A low blood sugar level, or hypo, can also happen while you’re sleeping. This may cause you to wake up during the night or cause headaches, tiredness or damp sheets in the morning.
The Causes Of Low Blood Sugar
Low blood sugar levels can happen to kids with diabetes because of the medicines they have to take. Kids with diabetes may need a hormone called insulin and/or diabetes pills to help their bodies use the sugar in their blood. These medicines help take the sugar out of the blood and get it into the body’s cells, which makes the level of sugar in the blood go down.
But sometimes it’s a tricky balancing act, and blood sugar levels can get too low. Kids with diabetes need to keep their blood sugar levels from getting too high or too low. How do they do it? With help from grown-ups, they keep three things in balance:
Each one of these can affect the other. For instance, eating more might mean a kid needs more insulin. And exercising might create the need for an extra snack. Again, a grown-up can help you learn how to juggle those three activities so you keep feeling good.
Some things that can make low blood sugar levels more likely to happen are:
- skipping meals and snacks
- not eating enough food at a meal or snack
- exercising longer or harder than usual without eating something extra
- getting too much insulin
- not timing the insulin doses properly with meals, snacks, and exercise
- taking a long bath or shower right after an insulin shot
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What Are Clinical Trials For Low Blood Glucose
Clinical trialsand other types of clinical studiesare part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future.
Researchers are studying many aspects of low blood glucose levels in diabetes, such as
- how to diagnose and treat low blood glucose among people with diabetes
- medicines that can treat symptoms of low blood glucose in people with hypoglycemia unawareness
- educational approaches to reduce fear of low blood glucose, which can make it harder for you to control your diabetes
What If I Have Severe Low Blood Glucose And Cant Treat Myself
Glucagona hormone that raises blood glucose levelsis the best way to treat severely low blood glucose. Available as an injection or a nasal spray, glucagon will quickly raise your blood glucose level. Your doctor can prescribe you a glucagon kit for use in case of an emergency.
If your blood glucose level drops very low, you wont be able to treat it by yourself. Be prepared to address severely low blood glucose by
- talking with your doctor or health care team about when and how to use a glucagon emergency kit. If you have an emergency kit, regularly check the date on the package to make sure it hasnt expired.
- teaching your family, friends, and coworkers when and how to give you glucagon. Tell them to call 911 right away after giving you glucagon or if you dont have a glucagon emergency kit with you.
- wearing a medical alert identification bracelet or pendant. A medical alert ID tells other people that you have diabetes and need care right away. Getting prompt care can help prevent the serious problems that low blood glucose levels can cause.
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Treating Severely Low Blood Sugar
Blood sugar below 55 mg/dL is considered severely low. You wont be able to treat it using the 15-15 rule. You also may not be able to check your own blood sugar or treat it by yourself, depending on your symptoms. Make sure your family members, friends, and caregivers know your signs of low blood sugar so they can help treat it if needed.
Injectable glucagon is the best way to treat severely low blood sugar. A glucagon kit is available by prescription. Speak with your doctor to see if you should have a kit. Be sure to learn how and when to use it. Let family members and others close to you know where you keep the glucagon kit and make sure theyve been trained in how to use it too.
Its important to contact a doctor for emergency medical treatment immediately after receiving a glucagon injection. If a person faints due to severely low blood sugar, theyll usually wake up within 15 minutes after a glucagon injection. If they dont wake up within 15 minutes after the injection, they should receive one more dose. When the person is awake and able to swallow:
- Feed the person a fast-acting source of sugar .
- Then, have them eat a long-acting source of sugar .
Its also important that friends, family, co-workers, teachers, coaches, and other people you may be around often know how to test your blood sugar and treat severely low blood sugar before it happens.
If any of the following happens, your friend, relative, or helper should call 911:
Signs That Blood Sugar Levels Are Low
There are a bunch of symptoms that someone with low blood sugar might have. It’s not the same for everybody. The symptoms are as minor as feeling hungry and as serious as having seizures or passing out. Have you ever had low blood sugar? If so, do you remember how it felt? Noticing those problems early can help you if it happens again.
If you have diabetes and you have low blood sugar, you may:
- feel hungry or have “hunger pains” in your stomach
- feel shaky or like you’re trembling
- have a rapid heart rate
- feel sweaty or have cold, clammy skin
- have pale, gray skin color
- have a headache
- be unsteady or stagger when walking
- have blurred or double vision
If you think your blood sugar level could be low, tell a parent, teacher, or whoever is taking care of you. An adult can help you test your blood and get you treatment so you start feeling better.
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How To Treat Someone Who’s Having A Seizure Or Fit
Follow these steps if someone has a seizure or fit caused by a low blood sugar level:
Tell your diabetes care team if you ever have a severe hypo that caused you to have a seizure or fit.
Oral Dextrose Gel For The Treatment Of Newborn Infants With Low Blood Glucose Levels
Review question
For newborn infants who develop low blood glucose levels , is sugar gel given by mouth more effective than no treatment or other active treatments in correcting the low blood glucose level and reducing long-term neurodevelopmental impairment?
Background
Low blood glucose levels in newborn infants are common and occur frequently in certain at-risk groups , infants born preterm, small and large infants). Infants with low blood glucose levels are at higher risk for developmental problems later in childhood. To manage this condition, active treatments are generally used, frequently requiring the use of formula milk or admission to the neonatal intensive care unit to receive fluid infusion into the veins, resulting in temporary separation from the mother. Sugar gel applied to the inside of the mouth is a simple and low-cost option for the initial care of infants with low blood glucose levels. We are exploring whether oral dextrose is more effective than no treatment or other active treatments in correcting low blood glucose levels in newborn infants and reducing its long-term effects on neurodevelopment.
Study characteristics
Two studies in high-income countries have assessed theuse of oral dextrose gel to reverse low blood glucose levels in a total of 312 infants. Investigators rubbed oral dextrose gel into the inside of the infant’s cheek for 157 of these infants and rubbed in placebo gel or no gel for 155 infants, and then gave a normal feed.Key results
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What Causes Low Blood Glucose In People With Diabetes
Low blood glucose levels can be a side effect of insulin or some other medicines that help your pancreas release insulin into your blood. Taking these can lower your blood glucose level.
Two types of diabetes pills can cause low blood glucose
- sulfonylureas, usually taken once or twice per day, which increase insulin over several hours
- meglitinides, taken before meals to promote a short-term increase in insulin
The following may also lower your blood glucose level
When You Have Low Blood Sugar
First, eat or drink 15 grams of a fast-acting carbohydrate, such as:
- Three to four glucose tablets
- One tube of glucose gel
- Four to six pieces of hard candy
- 1/2 cup fruit juice
- 1/2 cup soft drink
- 1 tablespoon honey
Fifteen minutes after youve eaten a food with sugar in it, check your blood sugar again. If your blood sugar is still less than 70 mg/dL, eat another serving of one of the foods listed above. Repeat these steps until your sugar becomes normal.
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Whats The Link Between Diabetes And Hypoglycemia
Hypoglycemia is most common, by far, in people with diabetes. Treatment for the diseaseoften involves taking medication to increase insulin. Hypoglycemia can develop if things like food, exercise and diabetes medications are out of balance.
Common pitfalls for people with diabetes include:
- Being more active than usual.
- Drinking alcohol without eating.
- Eating late or skipping meals.
- Not balancing meals by including fat, protein and fiber.
- Not eating enough carbohydrates.
- Not timing insulin and carb intake correctly .
Also, if someone with diabetes uses the wrong insulin, takes too much or injects it incorrectly, that can cause hypoglycemia.
Summary Of Study Characteristics
The body of evidence includes two Cochrane SRs,, one RCT, and six NRS that addressed the clinical effectiveness of oral glucose gel for neonatal hypoglycemia. One economic evaluation was identified that was a cost-analysis based on a RCT included in one of the SRs, and two evidence-based guidelines,, provide recommendations to inform the use of oral glucose gel. Study characteristics are summarized below. Additional details regarding the characteristics of the included publications are available in : , , and .
Study Design
Systematic Reviews
Randomized Controlled Trial
The included RCT reported on a subset of the original study population from the Sugar Babies Study that is included in one of the SRs. This study was a prospective, doubleblind, placebo-controlled RCT conducted at a single tertiary centre in New Zealand that assessed whether oral dextrose gel was more effective than placebo for reversal of neonatal hypoglycemia in 237 hypoglycemic babies. The study that is included in this report provides prospectively-collected data on feeding that was not included in the original publication following treatment of 1 to 2 episodes of neonatal hypoglycemia in 211 babies.
Non-Randomized Studies
Further information about the characteristics of the included RCT and NRS is available in : .
Economic Evaluation
Guidelines
Year of Publication and Country of Origin
Patient Population
Systematic Reviews
Randomized Controlled Trial
Non-Randomized Studies
Economic Evaluation
Guidelines
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