Summary of findings 3. Oral + buccal glucose (dextrose gel) compared to oral (swallowed) glucose for treatment of hypoglycaemia.
| Oral + buccal glucose (glucose gel) compared to oral (swallowed) glucose for treatment of hypoglycaemia | ||||||
| Patient or population: adult patients with insulin‐dependent diabetes Setting: first‐aid setting, hospital Intervention: oral + buccal glucose (glucose gel) Comparison: oral (swallowed) glucose | ||||||
| Outcomes | Risk with oral (swallowed) glucose | Risk with oral + buccal glucose (glucose gel) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments |
| Resolution of symptoms within 20 minutes | 917 per 1000 | 330 per 1000 (110 to 1000) | RR 0.36 (0.12 to 1.14) | 18 (1) | ⊕⊝⊝⊝ very lowa | |
| Time to resolution of symptoms | Not reported | |||||
| Blood/plasma glucose concentrations at 20 minutes | The mean blood/plasma glucose concentrations at 20 minutes was 77 mg/dL | The MD was 15.3 mg/dL lower (33.6 lower to 3 higher) | ‐ | 18 (1) | ⊕⊝⊝⊝ very lowb | |
| Resolution of hypoglycaemia | Not reported | |||||
| Time to resolution of hypoglycaemia | Not reported | |||||
| Adverse events | Not reported | |||||
| Ease of administration/treatment delay | Not reported | |||||
| CI: confidence interval; MD: mean difference; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
aDowngraded by one level because of risk of bias and by two levels because of serious imprecision ‐ see Appendix 16. bDowngraded by three levels because of very serious imprecision (small sample size, 1 study only, CI consistent with both benefit and harm) ‐ see Appendix 16.