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September 23, 2004

Hypoglycemia

Question from Taranaki, New Zealand:

I have just purchased a copy of the book Insulin-Dependent Diabetes in Children, Adolescents and Adults by Ragnar Hanas, M.D. On page 64, the book states that "Sugar must reach the Intestine to be able to be absorbed into the bloodstream so that it can raise the blood glucose level. Glucose cannot be absorbed through the lining of the mouth (oral mucosa) or from the stomach." This is contrary to be what I have been advised by my doctor, who stated that if my three year old daughter was hypoglycemic and unable to swallow, I could rub InstaGlucose or glucose gel into her gums and cheek linings and this would help. Please could you clarify this for me?

Answer:

This is somewhat controversial, but the best information is what is quoted in Dr Hanas’ book. There is some absorption from the oral mucosa and that is why oral glucose gel may also work. But, most diabetologists would use glucagon under such circumstances when someone is so unconscious or hypoglycemic that oral intake would potentially be dangerous because of choking concerns. You should show the book to your physician and then have a discussion specific for you child, of course.

SB