Criteria

Your Organizational Guidance

ebpracticenet urges you to prioritize the following organizational guidance:

Beleid bij acute hypoglykemie met verminderd bewustzijnPublished by: Werkgroep Ontwikkeling Richtlijnen Eerste Lijn (Worel)Last published: 2022La prise en charge de l’hypoglycémie aiguë chez un patient présentant une diminution de la consciencePublished by: Groupe de Travail Développement de recommmandations de première ligneLast published: 2022

Severity of hypoglycemia[1][3]​​​[4][5]​​​​

Level 3 (severe)

No defined blood glucose.​ Severe event characterized by altered mental and/or physical status requiring assistance for treatment of hypoglycemia.

Level 2 (clinically significant; also referred to as clinically important or serious)

Blood glucose <54 mg/dL (<3.0 mmol/L). This is usually the threshold at which neuroglycopenic symptoms occur. In addition, be aware that a patient with impaired awareness of hypoglycemia may not present with typical signs and symptoms of hypoglycemia.

Level 1 (alert value)

Blood glucose <70 mg/dL (<3.9 mmol/L) and ≥54 mg/dL (≥3.0 mmol/L).​​ This value should alert the patient to the possibility of developing level 2 hypoglycemia and can be used as a threshold to take appropriate actions to prevent this (e.g., carbohydrate ingestion, adjusting drug treatment).

Types of hypoglycemia

A 2013 workgroup of the American Diabetes Association and the Endocrine Society proposed a set of criteria for the types of hypoglycemia, based on presence of symptoms and blood glucose:[2]

  • Documented symptomatic hypoglycemia: symptoms of hypoglycemia occur and measured blood glucose is <70 mg/dL (<3.9 mmol/L).

  • Asymptomatic hypoglycemia: symptoms of hypoglycemia do not occur but measured blood glucose is <70 mg/dL (<3.9 mmol/L).

  • Probable symptomatic hypoglycemia: symptoms of hypoglycemia occur. Blood glucose is not measured but is presumed to be <70 mg/dL (<3.9 mmol/L).

  • Pseudo-hypoglycemia: symptoms of hypoglycemia occur but measured blood glucose is not <70 mg/dL (<3.9 mmol/L), but is approaching that level.

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