ECE2015 Eposter Presentations Diabetes (complications & therapy) (143 abstracts)
Eighteen grams of glucose are necessary to treat severe hypoglycaemia: experience from the Emergency Medical Services Department
Charlotte Cohen 1, , Marinos Fysekidis 3 , Célia Etiennar 1 , Lucie Ginaux 1 , Jean-Luc Sebbah 1 , Régis Cohen 2 & Philippe Lakhnati 1
1SMUR Centre Hospitalier de Gonesse, Gonesse, France; 2Hopital Delafontaine, Saint Denis, France; 3Hôpital Avicenne, Bobigny, France.
We know that non-severe hypoglycaemia (SH) should be treated with the immediate intake of 15–20 g of oral glucose, there are no data according to our knowledge in the current literature for the dose of glucose that is necessary to inject in SH. We have analysed retrospectively the treatment of pre hospital SHs as reported after an emergency call for intervention. Our primary objective was to know the dose of the given glucose and our secondary objective was to know the factors involved in determining these doses. Between April 2012 and December 2013 148 cases with SH were analysed retrospectively. A total of 104 cases (77 patients) were included in the final analysis, there were 29 women, patients had a mean age of 62±19 years and 62/77 were on insulin therapy. The kidney function, the insulin dose and the duration of symptoms on arrival was unknown in most cases. Almost half of the patients (49.53%) were admitted in the nearby hospital. after the intervention Patients that were not admitted had a pasta meal. Average blood glucose on arrival was 29 and 121 mg/dl at the departure of the emergency team. The average dose of injected glucose was 18 g (range 6–69 g) according to the following procedure (first injection, 7 g glucose; second, 6 g; third, 5 g; mean glucose levels were 83±33 for second and 108±57 mg/dl for the third injection). The administered dose was inversely correlated with the duration of the intervention (β=−0.267, P=0.007) and the Glasgow index (β=−0.357, P=0.001) even after adjustment for patient’s age. It seems that treatment is guided from the clinical severity of consciousness and can be treated injecting 60 ml glucose 30% (18 g of glucose), for most patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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