A decade plus of research by Wellington doctors and nurses into the best treatment for low blood sugar may lead to a re-write of international guidelines for diabetes.

The team at Capital & Coast District Health Board and University of Otago Wellington looked at whether a person’s weight was a better way of calculating the carbohydrate/glucose dose to treat hypoglycaemia (low blood sugar) in children and adults with diabetes than the current guidelines.

Hypoglycaemia symptoms include fatigue, dizziness, blurred vision and confusion and can be resolved within 10-12 minutes if treated correctly and quickly.

Current international guidelines are to give children 10 grams of glucose, and adults 15 grams, no matter their size.

Lindsay McTavish, a lead researcher and clinical nurse specialist diabetes, said those guidelines were based on expert opinion, rather than practical first-hand experience and knowledge.

He said he and the research team of Drs Brian Corley, Mark Weatherall, Esko Wiltshire and Jeremy Krebs carried out four clinical trials over 10 years to try to find whether there was a faster and more effective way to treat hypoglycaemia. The latest research findings were published this month in the British journal Diabetic Medicine.

The research found that a weight-based method was the best way of managing a hypoglycaemia event. As such, both Capital & Coast and Hutt Valley DHBs switched to a weight-based approach 10 years ago for children and five years ago for adults.

McTavish said the evidence was clear for type 1 diabetes, and there was a subtle difference for type 2. The weight-based protocol is better than the standard dose recommended internationally, but was similar to a bigger fixed dose of 30g of glucose used on CCDHB wards.

“We’ve demonstrated that larger people need more glucose to overcome hypoglycaemic events resolve an event – in contrast to the international guidelines that don’t take a patient’s size into account.

“If reviewed and adopted, these studies could change how hypoglycaemia is treated and managed internationally – giving doctors and patients clearer direction about how to resolve symptoms faster.”

Read more about the clinical trials – study onestudy twostudy three, and study four.

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