Glucose Supplement Pregnancy: A — safe for maternal hypoglycaemia

Dextrose 50% (Glucose 50%)

Brand names: Glucose 50% Injection

Adult dose

Dose: 50ml (25g glucose) IV — prefer 200ml of 10% if available

Route: IV via large bore cannula — flush well after

Frequency: Repeat at 10 min if BM <4 mmol/L

Max: 150ml in one hypoglycaemic episode

Confirm IV patency before administration — 50% glucose is highly irritant and causes tissue necrosis if extravasated. Always follow with oral carbohydrates.

Paediatric dose

Dose: 2 mL/kg

Route: IV (use 10% glucose — NOT 50%)

Frequency: Single dose; check BM at 10 min

Max: 50ml

Age bands

0–3m: 2.5–5ml/kg of 10% glucose IV
3–216m: 2ml/kg of 10% glucose IV (max 50ml)

Paediatric weight-based calculator

Patient weight (kg)

Clinical pearls

In alcoholism or malnutrition: ALWAYS give thiamine (Pabrinex 1–2 pairs IV over 30 min) BEFORE dextrose to prevent precipitating Wernicke's encephalopathy.
Use 10% glucose (200ml) in preference to 50% glucose if available — same glucose dose, less vascular damage, slower BM rise.
NEVER use 50% glucose in infants — use 10% glucose at 2ml/kg. 50% is a paediatric contraindication.
After IV correction: always give oral carbohydrate (125ml Lucozade or 3 glucose tablets) to prevent rebound hypoglycaemia.

Contraindications

Malnourished / alcoholic patients — must give thiamine FIRST to prevent Wernicke's
Hyperglycaemia
Intracranial haemorrhage (relative — hyperglycaemia worsens neurological outcome)

Side effects

Tissue necrosis and venous thrombosis if extravasated
Rebound hypoglycaemia
Hyperglycaemia and osmotic diuresis
Hypokalaemia
Wernicke's encephalopathy in thiamine-deficient patients

Interactions

Insulin: opposing effects
Thiamine: MUST give before dextrose in malnourished/alcoholic patients

Monitoring

Blood glucose at 10 min
20 min
30 min post-treatment. Repeat until BM ≥5 mmol/L on two readings.

Reference: BNFc; JBDS Inpatient Hypoglycaemia Guidelines 2023; NICE CG100; NICE BNF 84. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

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