Observation duration longer than insulin-only hypoglycemia
Avoid iatrogenic hyperglycemia
Titrate infusion to physiologic targets
Reassess need for ongoing dextrose frequently
Patient Discharge Instructions
copy discharge instructions
Discharge instructions
What happened
Low blood sugar episode treated and improved
Likely trigger identified when known
What to do today
Eat a meal with complex carbohydrates and protein
Avoid skipping meals for the next 24 hours
Check glucose more often for the next 24 hours
Medication safety
Do not take extra insulin or diabetes pills to compensate for high readings today
Follow the medication adjustment plan provided
Keep fast sugar available at all times
How to treat a mild episode at home
If glucose below 4.0 mmol/L, take fast sugar 15 g
Recheck in 15 minutes
Repeat 15 g if still below 4.0 mmol/L
After recovery, eat a snack with complex carbohydrates
When to return to the ED
Confusion
Seizure
Fainting
Glucose below 4.0 mmol/L that does not improve after two rounds of fast sugar
Repeated lows in the same day
Unable to keep food or fluids down
Concern for medication overdose
Follow-up
Diabetes clinician or primary care follow-up within 24 to 72 hours
Bring glucose logs or device data to the visit
Review insulin and pill doses and meal plan
References
Clinical guidelines and evidence sources
Reference set
American Diabetes Association Standards of Medical Care in Diabetes current edition hypoglycemia definitions and management
Endocrine Society clinical practice guideline on adult hypoglycemic disorders evaluation and critical sample concept
International Hypoglycaemia Study Group definitions for clinically significant hypoglycemia below 3.0 mmol/L
Toxicology references supporting octreotide for sulfonylurea-induced hypoglycemia with rebound prevention
Resuscitation guidance emphasizing immediate glucose assessment and correction in altered mental status and seizures
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.