acute

Hypoglycaemia

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources2 sources

Egyptian National Drug Formulary - endocrine.pdf, Glucagon monograph (chapter PDF p210) · Mathew P, Thoppil D. Hypoglycemia. [Updated 2022 Dec 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID: NBK534841. PMID: 30521262.

Verified against2 documents

Egyptian National Drug Formulary - endocrine.pdf, Glucagon monograph (chapter PDF p210)
Mathew P, Thoppil D. Hypoglycemia. [Updated 2022 Dec 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID: NBK534841. PMID: 30521262.

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (7)

Two families of features: those from the brain being starved of glucose, and those from the sympathoadrenal response
Brain starvation: altered behaviour, confusion, tiredness, fits, coma, and death if it is not corrected at once [coma · confusion · fatigue · seizures]
Adrenergic features are tremor, palpitations and anxiety; cholinergic ones are hunger, sweating and tingling [anxiety · palpitations · sweating · tingling · tremor]
Symptoms usually start at a glucose of 50 to 55 mg/dL or lower, but the threshold differs from person to person
People with diabetes can feel it at higher readings because long-standing high sugar shifts the set point, a false hypoglycaemia with a normal glucose
Ask about all medicines, alcohol and drug use, psychiatric history, and diabetes or MEN syndromes in the patient or family
Also ask about unplanned weight change, a change of drug, kidney injury or failure, hormone deficiency symptoms, and when the episode fell relative to meals or exercise

Signs — what you find (1)

What an observer sees: tremor, sweating, altered behaviour, confusion, a fit or coma [coma · confusion · seizures · sweating · tremor]

Tests (7)

No lab number defines it on its own: it needs matching symptoms together with a serum glucose under 70 mg/dL
It is a clinical picture paired with a lab result, not a chemistry finding by itself
Documenting the Whipple triad points to it, and the first labs should confirm the low glucose
During a suspected episode measure insulin, proinsulin and C-peptide
A low C-peptide alongside high insulin means the insulin came from outside the body
Both C-peptide and insulin high points to a sulfonylurea or another drug that drives the pancreas to secrete
Once injected insulin is excluded, hunt for the body making too much of its own, localised by abdominal CT or MRI

If not this — what else fits (1)

Once it is confirmed, the cause is chased through adherence to medicines and diet, any change of drug, possible kidney injury, and weight change, especially loss

SourceStatPearls "Hypoglycemia" - disease-level clinical article

Presentation findings are traced to the source above.

GLUCAGON

1st line

Forminjection

Adult dose and duration

1 mg by intramuscular, subcutaneous, or intravenous injection; may repeat after 15 minutes if needed.

Paediatric dose

Dose by age
Children weighing less than 20 kg:	0.5 mg IM, SC, or IV; may repeat after 15 minutes if needed.

Dose source

Egyptian National Drug Formulary - endocrine.pdf, Glucagon monograph (chapter PDF p210)

Why

Glucagon is the formulary-indicated emergency treatment for severe hypoglycaemia in diabetic patients who cannot take oral carbohydrate, a common emergency in Egypt's large insulin- and sulfonylurea-treated population.

Cautions

Severe hypoglycaemia with loss of consciousness or seizure is a medical emergency requiring urgent glucagon or intravenous glucose and hospital transfer.
Severe hypoglycaemia with loss of consciousness or seizure is a medical emergency - give glucagon or IV glucose immediately and arrange hospital transfer.
Glucagon is ineffective in patients with depleted glycogen stores (e.g. prolonged fasting, alcohol excess, adrenal insufficiency, chronic hypoglycaemia) - give IV glucose instead in these patients.
Give oral carbohydrate as soon as the patient is conscious and able to swallow, to prevent recurrence.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
GLUCAGEN 1MG/ML VIAL	NOVO NORDISK > EGYPTIAN PHARMACEUTICAL TRADING COMPANY	323.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.