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. Author manuscript; available in PMC: 2014 Feb 1.
Published in final edited form as: Curr Diab Rep. 2013 Feb;13(1):155–162. doi: 10.1007/s11892-012-0335-y

Table 2.

Preventing and managing hypoglycemia in patients receiving enteral and parenteral nutrition

  1. Prevention of hypoglycemia:

    • If tube feeding is interrupted:

      • -

        Start intravenous 10 % dextrose infusion 50 mL/h,

      • -

        Consider reducing next dose of long- or intermediate-acting insulin, and

      • -

        Increase frequency of bedside glucose monitoring

    • If parenteral nutrition is interrupted:

      • -

        Consider reducing next dose of long- or intermediate-acting insulin (if used)

    • Reduce dose of scheduled insulin if:

      • -

        Renal insufficiency

      • -

        Discontinuation or reduction in steroids

      • -

        Discontinuation of vasopressors

      • -

        Decrease in carbohydrate intake

  2. Management of hypoglycemia (BG<70 mg/dL):

    • Administer intravenously Dextrose 50 % 25–50 mL

      • -

        If repeat BG is <70 in 15 minutes, repeat dextrose intravenous push and start intravenous 10 % Dextrose infusion 50 mL/h

      • -

        If repeat BG is ≥70 in 15 min, measure BG in 1 hour, and repeat treatment until BG is >100 mg/dL

    • Administer intramuscular 1 mg Glucagon if there is no intravenous access present

    • Reduce or hold next dose of long- or intermediate-acting insulin (if used)