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. 2024 Jul 26;48(4):546–708. doi: 10.4093/dmj.2024.0249
1. For individuals who are conscious and have a blood glucose level below 70 mg/dL (<3.9 mmol/L), administer 15 to 20 g of glucose and repeat the glucose intake if the blood glucose level has not returned to average 15 minutes after the treatment. [Expert opinion, general recommendation]
2. If an individual is unconscious or unable to self-treat hypoglycemia, an intravenous infusion of 10 to 25 g of glucose should be administered over 1 to 3 minutes. [Expert opinion, general recommendation]
3. To prevent recurrence of hypoglycemia in patients using insulin or insulin secretion stimulants, it is suggested to measure self-blood sugar periodically even after blood sugar levels return to normal and eat if necessary. Alternatively, it is suggested to educate children to consume additional snacks. [Expert opinion, general recommendation]
4. To facilitate the restoration of impaired hypoglycemia awareness, individuals who have experienced SH should be cautioned to exercise vigilance against hypoglycemic episodes for a duration spanning weeks to months. [Randomized controlled trial, general recommendation]
5. Individuals with recurrent SH, the use of a rtCGM device is recommended. [Randomized controlled trial, limited recommendation]
6. When caring for individuals at high risk for hypoglycemia, it is suggested to carefully identify and regularly assess changes in cognitive function. [Non-randomized controlled trial, general recommendation]
7. During each visit, clinicians should screen individuals for the risk of hypoglycemia and provide comprehensive education on prevention and treatment to those identified as high risk. [Randomized controlled trial, general recommendation]
8. Clinicians should utilize validated tools to assess hypoglycemia unawareness in patients exhibiting indicative symptoms. [Non-randomized controlled trial, general recommendation]