First aid glucose administration routes for symptomatic hypoglycaemia

To help guide first-aid care, the International Liaison Comittee on Resuscitation (ILCOR) uses a continuous evidence evaluation process for resuscitation and relevant first-aid topics. This process culminates in the production of a consensus on science with treatment recommendations (CoSTR). Whilst previous work by ILCOR has helped to establish the role of oral glucose (i.e. tablets) over dietary sugars, the optimal enteral route for glucose administration was unknown. 

Therefore, the aim of this newly published Cochrane review was to answer the following research question: among adults and children with suspected hypoglycaemia, does administration of glucose by any route appropriate for use by first-aid providers, compared to administration of glucose by another route appropriate for use by first-aid providers, change resolution of symptoms, blood glucose concentration, resolution of hypoglycaemia, delay in treatment, or adverse events?

The review found 4 studies, including 77 participants, that compared different routes of glucose administration in people with hypoglycaemia or healthy volunteers. The studies provided evidence of very low certainty, which means we remain unsure about the most effective route for glucose administration in people with hypoglycaemia.

This review by De Buck et al. was conducted in co-operation with the ILCOR First Aid Task Force and is now published in the Cochrane Database of Systematic Reviews.