Overtreatment

Overtreatment, leading to hyperglycaemia should be avoided as this can make glycaemic control difficult for the patient to manage over the following hours.

Hyperglycaemia also has a deleterious effect in many conditions:

• Sepsis
• Myocardial infarction
• Stroke

In most cases capillary blood glucose in the range 5-10 mmol/L are appropriate after treatment for hypoglycaemia.

Glucagon stimulates insulin secretion as well as glycogenolysis so is less useful in type 2 diabetes when there is still insulin secretion.

Intravenous dextrose also stimulates insulin release, which can then cause rebound hypoglycaemia, this is particularly important in hypoglycaemia associated with sulphonylureas.