Assess whether the patient can swallow: If able to swallow, give approximately 10–20 g of a fast-acting carbohydrate, such as glucose tablets, dextrose tablets, fruit juice, sugar in water, jelly babies, or glucose gel NICE CKS.
Recheck blood glucose: After 10–15 minutes, recheck blood glucose levels NICE CKS.
Repeat if necessary: If there is no response or blood glucose remains low, repeat the fast-acting carbohydrate and recheck after another 15 minutes NICE CKS.
Provide longer-acting carbohydrate: Once symptoms improve or blood glucose normalizes, advise on consuming a longer-acting carbohydrate to prevent recurrence, such as bread, potatoes, pasta, or a snack like a sandwich or banana NICE CKS.
If the patient is unconscious or unable to swallow: Administer intramuscular (IM) glucagon immediately—1 mg for adults and children over 8 years or over 25 kg, or 500 micrograms for children under 8 or under 25 kg NICE CKS.
Seek emergency help: Arrange urgent transfer to hospital if IM glucagon is unavailable or if the family/carers are not trained to administer glucagon NICE CKS.