Authors: (including presenting author): :
Sin WMC(1), Chan HK(1), Lam KM(1), Ng HYI(2), Tsang LF(3), Mok PH (1), MP Ng (1), Kam YW(2)
Affiliation: :
(1) Diabetes Ambulatory Care Centre (DACC), United Christian Hospital, (2) Department of Medicine and Geriatrics, United Christian Hospital, (3) Nursing Services Division (NSD), United Christian Hospital
Keyword 1: :
Diabetes Mellitus
Keyword 2: :
Hypoglycaemia
Keyword 4: :
Effectiveness
Introduction: :
Hypoglycaemia is most common among Type 1 diabetic mellitus (DM) patients due to intensive insulin therapy. The conventional fixed-dose treatment of 15 g of glucose, which was based on expert opinion only (level 4 evidence), ignores the influence of body weight over the treatment response. Overseas recommendations for treating hypoglycaemia vary between organisations and suggested a weight-based treatment protocol may be beneficial.
Objectives: :
We aim to compare the effectiveness of weight-based provision of glucose and standardized dose(15 g) of glucose in managing hypoglycaemia in Type 1 DM adult patients.
Methodology: :
This is a cross-over trial comparing weight-based approach with standardized dose of glucose in managing hypoglycaemia for Type 1 DM patients. Patients were recruited from Dec 2024 to Sept 2025 in DACC of UCH. Group 1 subjects took standardized dose of glucose for the first episode of hypoglycaemia, and then switch to weight-based approach (0.3 g/kg) for the 2nd episode. Group 2 subjects took the reverse order of management. Patients were given glucometers and test strips, and educated for measurement of glucose level at home. The glucose levels were linked and reviewed by nurses at DACC through a mobile App (Health2syn) two times daily. Glucose levels were measured 15 minutes after treatment to assess the effectiveness of management. The primary outcome was the difference in glucose level of the two groups before and after the treatment. The results were compared using paired t-test.
Result & Outcome: :
A total of 60 patients were recruited with 15 males and 35 females, and mean age of 46.8 years (SD: 16.8 years). Their mean body weight was 60.35 kg (SD: 8.72kg) and mean duration of DM was 19.1 years (SD:10.5 years), with no statistical difference between the two groups. The mean difference in glucose level before and after the treatment for weight-based treatment was 2.80mmol/L (SD: 1.41mmol/L), slightly higher than that (mean 2.68mmol/L, SD:1.29mmol/L) of standard treatment, but was not statistically significant (p=0.70). The current study supports the conventional 15g of treatment for hypoglycaemia. Further large-scale research is recommended to better examine whether weight-based treatment is more effective in revoking hypohyglcaemia than conventional management.
