Criteria

Severity of hypoglycaemia[105]

Level 3 (severe)

No defined blood glucose.[3][4]​ Severe event characterised by altered mental and/or physical status requiring assistance for treatment of hypoglycaemia.[3][4]

Level 2 (clinically significant; also referred to as clinically important or serious)

Blood glucose <3.0 mmol/L (<54 mg/dL).[3][4]​​ This is usually the threshold at which neuroglycopenic symptoms occur.[3] In addition, be aware that a patient with impaired awareness of hypoglycaemia may not present with typical signs and symptoms of hypoglycaemia.​[1][3]

Level 1 (alert value)

Blood glucose <3.9 mmol/L (<70 mg/dL) and ≥3.0 mmol/L (≥54 mg/dL).[3][4]​​ This value should alert the patient to the possibility of developing level 2 hypoglycaemia and can be used as a threshold to take appropriate actions to prevent this (e.g., carbohydrate ingestion, adjusting medication).[1][5]​​​

Types of hypoglycaemia[2]

A workgroup of the American Diabetes Association and The Endocrine Society has proposed a set of criteria for the types of hypoglycaemia, based on presence of symptoms and blood glucose.[2]

Documented symptomatic hypoglycaemia

Symptoms of hypoglycaemia occur and measured blood glucose is <3.9 mmol/L (<70 mg/dL).[2]

Asymptomatic hypoglycaemia

Symptoms of hypoglycaemia do not occur but measured blood glucose is <3.9 mmol/L (<70 mg/dL).[2]

Probable symptomatic hypoglycaemia

Symptoms of hypoglycaemia occur.[2] Blood glucose is not measured but is presumed to be <3.9 mmol/L (<70 mg/dL).[2]

Pseudo-hypoglycaemia

Symptoms of hypoglycaemia occur but measured blood glucose is not <3.9 mmol/L (<70 mg/dL), but is approaching that level.[2]

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