Comparison of intravenous glucagon and dextrose in treatment of severe hypoglycemia in an accident and emergency department.
Hypoglycemia is a serious problem in insulin-treated diabetic patients. In this study the efficacy of intravenous glucagon (1 mg) was compared with that of intravenous dextrose (25 g) in the treatment of hypoglycemia in insulin-treated patients attending an accident and emergency department. In addition, the prevailing glycemic control of these patients was compared with patients routinely attending a diabetic outpatient clinic. Both intravenous glucagon and dextrose were effective in the treatment of hypoglycemic coma. There was a difference in the glycemic profile after intravenous glucagon compared with intravenous dextrose, and recovery of a normal level of consciousness after glucagon was slower than after dextrose (6.5 vs. 4.0 min, respectively; P less than .001), although the average duration of hypoglycemic coma was 1.4 h. The glucagon- and dextrose-treated groups had significantly lower HbA1 than comparable patients routinely attending the clinic (9.5 +/- 0.8 vs. 12.0 +/- 3.8%, respectively; P less than .001). In view of the ease of administration and the small risk of vascular and extravascular complications, intravenous glucagon appears to be a useful alternative to intravenous dextrose in the treatment of severe hypoglycemia.
Diabetic and Dietetic Department, Royal Infirmary, Edinburgh, United Kingdom.
A
A
Collier
D J
DJ
Steedman
A W
AW
Patrick
G R
GR
Nimmo
D M
DM
Matthews
C C
CC
MacIntyre
K
K
Little
B F
BF
Clarke
D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D004630:Emergencies; D005934:Glucagon / Q000008:administration & dosage / Q000627:therapeutic use*; D005947:Glucose / Q000008:administration & dosage / Q000627:therapeutic use*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy*; D010349:Patient Compliance
D001786:Blood Glucose; D005934:Glucagon; D005947:Glucose; D006442:Glycated Hemoglobin