Criteria

Severity of hypoglycemia[104]

Level 3 (severe)

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

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

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

Level 1 (alert value)

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

Types of hypoglycemia[2]

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

Documented symptomatic hypoglycemia

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

Asymptomatic hypoglycemia

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

Probable symptomatic hypoglycemia

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

Pseudo-hypoglycemia

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

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