Diabetes Unscheduled Care Pathway- Hypoglycaemia

This is a visual format of the pathway for more pathway information such as assessment and diagnosis go to the Clinical Guidance tab.

Protocol of the management of confirmed hypoglycaemia (low blood glucose) in the community (capillary (finger prick) blood glucose of <4mmol/L)

Hypoglycaemia - presentation, diagnosis and management

Hypoglycaemia is defined as a blood glucose below 4mmol/L. All hypoglycaemia should be treated aggressively.

Not all patients with hypoglycaemia will have symptoms or be aware of signs of hypoglycaemia. All patients on glucose lowering therapy should be provided with advice and education on avoidance, recognition and treatment of hypoglycaemia.

If the patient is able to treat the event themselves this is classified as minor hypoglycaemia. If third party intervention is required to treat the event this is classed as severe hypoglycaemia

Minor hypoglycaemia

Patients should not require admission to hospital for minor hypoglycaemia. Initial treatment should be self-administered or with the support of their GP, practice nurse or CDS.

Moderate hypoglycaemia

Patients with recurrent hypoglycaemia or with loss of hypoglycaemic awareness seek advice from the appropriate care provider.

Severe hypoglycaemia

Patients with severe hypoglycaemia are likely to require support from their family/carer or present via acute services i.e. paramedic service.

Patients may require hospital admission if they do not respond to initial treatments and their glucose levels fail to return to acceptable levels.

Patients who access care from the diabetes team at GHNHSFT will require review by this team.


Patients experiencing hypoglycaemia should be managed in the community in the majority of cases. Patients experiencing major hypoglycaemia may require secondary care assessment; follow up should remain with their main care provider.

Stratification of the hypoglycaemia pathway is to assist in the management of patient flow to the most appropriate care provider. Seek advice at an early stage for patients that give cause for concern - Community Diabetes Service.

Please see pathway visual flow chart.