- Is he conscious and able to swallow?
- Does he have diabetes — on insulin or a sulfonylurea?
- Has he been eating? Any recent insulin given?
Do now
- Treat now — don’t wait for a lab glucose
- Recheck CBG 10–15 min after treatment
- Once > 4: give a longer-acting carbohydrate
- Find out why and adjust insulin / sulfonylurea (don’t omit basal insulin in type 1)
Key doses
- Able to swallow: 15–20 g fast-acting carbohydrate (e.g. 150–200 mL fruit juice); repeat up to 3 times
- Unable to swallow / drowsy: 150–200 mL 10% glucose IV over 15 min
- No IV access: glucagon 1 mg IM (less effective after sulfonylureas or in liver disease)
Typical adult doses — always check the BNF and your local guideline.
Call your senior if
- Reduced consciousness or seizures
- Recurrent hypos or sulfonylurea-related (prolonged)
- Not responding to treatment
Think of
- Insulin / sulfonylurea excess
- Missed meals / NBM
- Sepsis
- Renal or liver failure
- Alcohol
Go deeper
The full walkthroughs behind this call.