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Published on: September 26, 2012
First aid glucose administration routes for symptomatic hypoglycaemia
Emmy De Buck1, Vere Borra, Jestin N Carlson
1Centre for Evidence-Based Practice (CEBaP), Belgian Red Cross, Motstraat 42, Mechelen, Belgium, 2800.
The best enteral route for glucose administration in first aid for hypoglycemia is unclear. Oral glucose may be more effective than buccal administration, and sublingual sugar shows promise in specific pediatric cases, but evidence is very low quality.
Area of Science:
- Clinical Medicine
- Pharmacology
- Emergency Medicine
Background:
- Hypoglycaemia (low blood glucose) is common in diabetes and can occur without diabetes.
- The optimal enteral route for glucose administration in first aid for suspected hypoglycaemia is not established.
Purpose of the Study:
- To evaluate the effectiveness of first aid glucose administration via enteral routes (buccal, sublingual, oral, rectal) for symptomatic hypoglycaemia.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) and non-RCTs.
- Searched multiple databases (CENTRAL, MEDLINE, Embase, CINAHL) and grey literature up to July 2018.
- Assessed risk of bias using Cochrane 'Risk of bias' tool and ROBINS-I; evaluated evidence certainty using GRADE.
Main Results:
- Four studies (77 participants) were included; all had a high risk of bias.
- Sublingual sugar showed higher blood glucose than oral in children with malaria/respiratory illness (very low-quality evidence).
- Buccal administration showed lower glucose than oral in one study; oral glucose favored in another (very low-quality evidence).
Conclusions:
- Oral glucose may yield higher blood glucose than buccal administration.
- Sublingual sugar may be beneficial in specific pediatric cases, but overall evidence is very low quality.
- Results require cautious interpretation due to study limitations and small sample sizes.
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