Mismatch in glucose supply, glucose utilisation, and circulating insulin. Blood glucose <4mmol/L

Poor oral intake, Missed/delayed meal, drugs (insulin, sulfonylureas), ethanol ingestion (delayed effect), diabetic gastroparesis, Addison’s disease, post exercise in insulin or SU treated subjects, sepsis, Insulinoma

Autonomic: tachycardia, tremor, pallor 

Neuroglycopaenic: incoordination, aggression, drowsiness, slurred speech, 

confusion, coma, personality change

Autonomic: Anxiety, sweating, hunger, palpitations 

Neuroglycopaenic: clumsiness, amnesia

Bloods: Glucose

Other: Assess for underlying cause, should be ordered if indicated; Short 

 synacthen test, serum insulin & c-peptide (in non-diabetes patients), 

 pituitary profile, 72 hour fast (hypoglycaemia survey)

Conscious patient: 20-30 g of quick acting carbohydrate (e.g. 4-6 dextrose tabs, 

100 ml Lucozade, 150 ml fruit juice) 

Unconscious: Glucagon 1mg IM or SC, 50 ml 20% dextrose IV. 

Follow up: Slow release carbohydrate, repeat glucose levels, and education to recognise and avoid further episodes

Usually good unless prolonged severe or recurrent hypoglycaemia

Injury, neurological (cognitive deficit, stroke), coma, death