Hypoglycaemia Severity Classification
Classifies a hypoglycaemic episode in diabetes by the International Hypoglycaemia Study Group / ADA levels: level 1 alert value (< 3.9 mmol/L), level 2 clinically significant (< 3.0 mmol/L), level 3 severe (needs assistance).
Score interpretation
→ Adults: rule of 15 — 15g fast-acting carbs (3-4 glucose tabs, 150mL juice); recheck in 15 min; if resolved eat a snack. Children: use a children's formulary. Review the cause and the glucose-lowering regimen.
→ Clinically significant hypoglycaemia — treat at once. Adults: 15–20 g fast-acting glucose, recheck after 15 min and repeat if still low, then a longer-acting carbohydrate. Children: use a children's formulary. Review insulin or sulfonylurea doses; check for impaired hypoglycaemia awareness.
→ Emergency: nothing by mouth if drowsy or unconscious. Adults: IV glucose 75mL 20% (or 150mL 10%) stat; IM glucagon 1mg if no IV access. Children: use a children's formulary. Call 999/emergency team; post-recovery safety check; find the cause (sulfonylurea hypoglycaemia can recur — admit); adjust the regimen.
Interpretation bands for the Hypoglycaemia Severity. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Insulin (IV Infusion — ICU Glucose Control) · Insulin — ICU Glucose Management
- Dextrose 10% IV · IV glucose solution (hypoglycaemia treatment)
- Glucose · Carbohydrate / hypoglycaemia treatment
- Glucagon · Hypoglycaemia Antidote / Endocrine Agent
- Sodium Chloride 3% (Hypertonic Saline) · Hypertonic Electrolyte Solution — ICP/Hyponatraemia Management
- Dextrose 50% (Glucose 50%) · Glucose Supplement
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022
- Hyperthyroidism Management · BTA / ETA 2018
- Adrenal Insufficiency · Society of Endocrinology / ESE 2016
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.