A. Administer Glucose. If hypoglycemia is strongly suspected, do not wait for results of serum glucose testing.

1. Oral. Preferred initial therapy if patient is awake and has an intact airway. Give orange juice by mouth or via nasogastric (NG) or orogastric (OG) tube.

2. Parenteral. In children, give a 2 mL/kg bolus of D25W IV or IO. In infants, give a 2-4 mL/kg bolus of D10W IV or IO. After the dextrose bolus, patient should be started on maintenance D10W electrolyte solution to provide glucose at a rate of 6-8 mg/kg/min.

3. Intramuscular or subcutaneous (IM or SQ). If no IV access is available, give glucagon IM or SQ.

b. Child or adolescent. Dose is 0.5-1 mg IM or SQ.

4. Other agents. Diazoxide, octreotide, and hydrocortisone may have a role in treatment of hypoglycemia, depending on the cause.

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