This protocol covers moderate to severe hypoglycemia — a blood glucose below 4.0 mmol/L — occurring in adults who are receiving enteral or parenteral nutritional support. The feeding route is central to how treatment must be delivered.
The patient is currently receiving enteral feeding (via a nasogastric or other feeding tube) or parenteral feeding, and capillary blood glucose has fallen below 4.0 mmol/L. This measurement threshold defines the intervention trigger for this protocol.
Because standard oral treatment options may not be feasible or safe, the choice of carbohydrate formulation and route of administration is determined by the type of feeding access in use — not all preparations are appropriate for every device or feeding line.
The first-line intervention involves administering rapid-acting carbohydrate, with the method and preparation selected according to the patient's specific feeding route. For patients on parenteral nutrition, the route of carbohydrate delivery differs from those on enteral feeding. The complete list of recommended preparations, step-by-step administration guidance, and tube-care considerations are specified in the full structured regimen.
Capillary blood glucose should be rechecked 10 to 15 minutes after treatment. A reading above 4.0 mmol/L confirms an adequate initial response.