LNSLNS The article recommends intravenous injection of a 20% glucose solution for the treatment of severe hypoglycemia and unconsciousness in type 1 diabetes mellitus in children, followed by continuous glucose infusion (1). It must be born in mind that this glucose solution is strongly hypertonic (1110 mosmol/L), so that it would be expected that this should irritate the wall of the vein. After repeated episodes of hypoglycemia and repeated glucose injections, all peripheral veins will be obliterated sooner or later. Rather than using high percentage glucose solutions, it is better to use isotonic 5% glucose solution, as even a slight increase in blood sugar is enough to recover consciousness. An alternative is treatment with IM glucagon (2).
DOI: 10.3238/arztebl.2010.0303a

Dr. med. Ora Seewi
Kinder-Endokrinologie und Diabetologie
Klinik und Poliklinik für Allgemeine Kinderheilkunde der Universität zu Köln Kerpener Str. 62
50924 Köln, Köln
ora.seewi@uk-koeln.de
1.
Meyburg J, Bernhard M, Hoffmann GF, Motsch J: Principles of pedi-atric emergency care. [Grundlagen für die Behandlung von Notfällen im Kindesalter]. Dtsch Arztebl Int 2009; 106: 739–48. VOLLTEXT
2.
Seewi O, Land C: Metabolische und endokrine Entgleisungen. In: Kretz FJ (ed.) Kinder Notfall-Intensiv. 3rd Edition. Elsevier 2010; 281–3.
1. Meyburg J, Bernhard M, Hoffmann GF, Motsch J: Principles of pedi-atric emergency care. [Grundlagen für die Behandlung von Notfällen im Kindesalter]. Dtsch Arztebl Int 2009; 106: 739–48. VOLLTEXT
2. Seewi O, Land C: Metabolische und endokrine Entgleisungen. In: Kretz FJ (ed.) Kinder Notfall-Intensiv. 3rd Edition. Elsevier 2010; 281–3.