Hypoglycaemia: Lucozade and glucagon appeared to be a safe pre-hospital management strategy

Clinical bottom line (level 2c)

  1. In patients with hypoglycaemia attended by ambulance staff and given Lucozade or glucagon i/m, 23% did not need any additional therapy
  2. In patients with hypoglycaemia attended by ambulance staff and given Lucozade or glucagon i/m, 60% attended A+E but required no or oral treatment
  3. In patients with hypoglycaemia attended by ambulance staff and given Lucozade or glucagon i/m, 17% required i/v treatment or admission to hospital
Steel et al: British Medical Journal 1992; 304: 1283-1284
Expires August 2003

The study

Prospective cohort study with objective outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

88 patients (aged ?, 64% female) hypoglycaemia diagnosed by Glucostix with altered mental status- 103 episodes in 88 diabetic patients

Excluded if
  • lack of cooperation


    • given oral glucose drink (Lucozade) if possible, or i/m glucagon (1mg) if not able to tolerate p.o.


    Outcomes studied:
  • recovery without hospitalisation
  • attended A+E but required no more than oral treatment
  • attended A+E, required i/v dextrose but no admission
  • admission to hospital

    • The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    recovery without hospitalisation ? 24/103 23%
    (15% to 32%)
    attended A+E but required no more than oral treatment ? 62/103 60%
    (51% to 70%)
    attended A+E, required i/v dextrose but no admission ? 10/103 10%
    (4% to 15%)
    admission to hospital ? 7/103 7%
    (2% to 12%)

    Citation

    1. Steel JM, Allwinkle J, Moffat R, et al: Use of Lucozade and glucagon by ambulance staff for treating hypoglycaemia. British Medical Journal 1992; 304: 1283-1284
    Contributor: Bob Phillips and Clare Wotton, August 1999
    Reviewer:

    Clinical Question.
    Patient adults with hypoglycaemia
    Intervention or Exposure treating with oral sugar drink (Lucozade)
    Comparison i/m glucagon
    Outcome quicker recovery to full consciousness