July 7, 2020
Protocol for the emergency Rx of hypoglycaemia during ITT and glucagon tests Minimize

 Protocol for the emergency treatment of hypoglycaemia during the insulin tolerance or glucagon tests


This procedure is a guide to the treatment of children who become hypoglycaemic (glucose < 2.6 mmol/L) during or after a glucagon test, or during an insulin tolerance test. The following equipment should be immediately available during the test procedure:

  1. liquid drink (squash/milk)
  2. food (toast/biscuits)
  3. glucose powder
  4. strong oral glucose solution (for diabetics)
  5. 10% dextrose (500 mL) and iv giving set
  6. Glucose meter and strips and lancets etc
  7. hydrocortisone 100 mg for iv use.

Emergency treatment:


Give a drink of milk/squash with 2-4 teaspoons of dextrose dissolved in it and recheck blood glucose after 10 minutes. If this is not successful, give 5-20 mL strong dextrose solution ORALLY. In most instances this will be sufficient to raise the blood glucose over 2 mmol/L. DO NOT ABANDON THE TEST AT THIS STAGE


  • Do not attempt oral therapy
  • Abandon the test procedure
  • Give intravenous glucose 200 mg/kg (10% dextrose at 2 mL/kg) over 3 minutes.

Emergency iv 10% glucose bolus dose




total volume



10 kg



20 mL



15 kg



30 mL



20 kg



40 mL



30 kg



60 mL



  • commence iv fluids with 0.45% NaCl/5% DExtrose at a maintenance rate
  • if hypogklycaemia recurs then repeat the iv glucose bolus as above
  • call the paediatric medical team to review the child 

Return to Insulin tolerance test



Return to Glucagon test for GSD



 JHB 17 Oct 2011





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