Glucose / Carbohydrate supplement OralOral (buccal)Buccal mucosaBuccal (cheek pouch)
Glucose Oral Gel
Oral glucose gel
CPG Reference
Hypoglycaemia
Indications
- ✓ Hypoglycaemia, altered conscious state in known person with diabetes or of unknown medical cause, where blood glucose level is below 4 mmol/L
Contraindications
- ✕ Patient unable to safely ingest gel orally/buccally
Precautions
- ⚠ Monitoring required: Blood Glucose Level
- ⚠ If unconscious, have patient in lateral position and airway patent
- ⚠ Do not delay transport for paediatric patients
- ⚠ Potential airway obstruction with oral administration, particularly in young children (under 1 year) — administer per instructions with caution
Dosing
Adult
Amount 15 g (entire contents of tube)
Route Oral
Repeat Repeat after 10 minutes if required
Administer only if GCS 15/15. Reassess GCS and BGL after 10 minutes. Follow up with complex carbohydrates (e.g. sandwich) to prevent delayed hypoglycaemia.
Paediatric (Child)
Amount 15 g administered in small amounts to effect
Route Oral (buccal)
Repeat Repeat after 10 minutes if required
Administer in small amounts. Do not delay transport for paediatric patients.
Paediatric (Neonate / Infant < 1 year)
Amount Small amount of gel — titrate to effect
Route Buccal mucosa — place small amount of gel onto gloved finger and massage into buccal mucosa
Titrate to effect. High risk of airway obstruction — administer with caution. Airway must be patent and patient positioned in lateral position if conscious state impaired.
Intermediate Care — Altered level of consciousness
Amount Small amount of gel at a time squeezed into the cheek pouch
Route Buccal (cheek pouch)
Repeat If no improvement after 10 minutes or patient deteriorates, reassess GCS and BGL; administer second dose if indicated
For altered consciousness — squeeze small amount into cheek pouch at a time. Reassess GCS and BGL after 10 minutes.
Onset: Refer to current CPG
Side Effects & Notes
Clinical Notes
- → Even if fully recovered, encourage patient to consume a long-acting complex carbohydrate (e.g. biscuit, bread) following oral glucose administration to prevent delayed hypoglycaemia.
- → Always treat diabetics with altered conscious state as having hypoglycaemia, as well as any other problems.
- → Diabetic patients taking Glucobay (Acarbose) have a greater glucose requirement.
- → Hypoglycaemia may present as a focal neurological deficit or coma — perform BGL on all patients with altered GCS.
- → Encourage transport post treatment.
- → Severe hypoglycaemia with loss of consciousness or seizure is outside EHS scope — Glucagon and IV Glucose are Advanced Care only.
- → At Primary Care level, oral glucose gel is only to be administered to patients with GCS 15/15. For altered consciousness, buccal administration via cheek pouch is an Intermediate Care step.