Nurses should no longer give diabetics Lucozade

Sufferers of low blood sugar spells have long been advised to consume a small amount of Lucozade Energy Original

Nurses should no longer give diabetics Lucozade to curb their dangerously low blood sugar, new guidelines state.

The fizzy drink has long been considered an effective emergency option to treat hypoglycaemia, the medical term for low blood sugar.

If left untreated, patients can slip into a diabetic coma or die.

But Lucozade’s formula was changed last April and its sugar content was halved in response to the Government’s crackdown on obesity.  

And now updated guidelines, published by the Joint British Diabetes Societies for Inpatient Care, have declared that the drink shouldn’t be relied on for patients who slip into the life-threatening state in hospital.

It states: ‘Lucozade and Ribena have been removed as suitable examples of a quick acting carbohydrate for the initial treatment for patients able to swallow.’

The updated guidelines, uncovered by The Diabetes Times, have been distributed to the Royal College of Nursing and 11 other specialist groups.

It has been supported by Diabetes UK, Association of British Clinical Diabetologists and the Diabetes Inpatient Specialist Nurse UK Group.

Nurses have also been re-advised that glucagon – the hormone that raises blood sugar when it drops – can be given without a prescription as a life-saving resort.

The guidelines apply to diabetics over 16 who are being treated for hypoglycaemia – blood sugar below 4 mmol/L – in hospital.

Diabetic patients experiencing a dizzy spell have long been advised to drink 20g of sugar to restore their blood glucose levels.

This used to be the equivalent of around 100ml of Lucozade Energy Original – before the drink’s recipe was updated.

Now, the new slashed sugar content of 8.9g per 100ml means patients need to consume double that amount to restore their levels.

If left untreated, hypoglycaemia can lead to a diabetic coma and be fatal. Figures suggest one in five diabetics suffer from a ‘hypo’ in hospital. 

The Hospital Management of Hypoglycaemia in Adults with Diabetes Mellitus was written by three experts from across the UK. 

It reads: ‘This guideline is aimed at all healthcare professionals involved in the management of people with diabetes in hospital.’

The publication, distributed this week, adds: ‘Many companies will change the formulation before 2018 and some already have.

HOW DOES DRINKING LUCOZADE WORK FOR DIABETICS?

To treat a hypoglycaemic episode – a period of dangerously low blood sugar, diabetics need to consume between 15 and 20g of sugar.

Sufferers can tell they are experiencing the potentially deadly condition when they suddenly feel tired, have difficulty concentrating or feel dizzy.

Experts recommend glucose tablets as they enter the bloodstream and restore blood sugar levels the fastest.

In terms of judging how much glucose a diabetic takes, they are the easiest form to monitor.  

The same amount can also be found in sugary drinks, such as 100ml of the old recipe for Lucozade Energy Original. Diabetics will have to consume double the amount to get the same sugar from the new recipe drink.

Despite being a little bit harder to judge on their sugar quantity, they are a good emergency option.

Source: Diabetes.co.uk 

‘Therefore Lucozade, which was commonly used to treat hypoglycaemia, is no longer recommended due to the quantities required to achieve 15-20g carbohydrate.’

The guidelines state, however, that fruit juices and ‘products specifically designed’ for the treatment of hypos are recommended instead.

Hospital staff haven’t been banned from using Lucozade, and are urged to check the carbohydrate content before giving it to patients. 

Esther Walden, a diabetes nurse from Norfolk and Norwich University Hospitals NHS Foundation Trust, was one of the authors of the guidelines.

Debbie Stanisstreet, lead nurse for diabetes and endocrinology at East and North Hertfordshire NHS Trust, and Dr Alex Graveling, from Aberdeen Royal Infirmary, also helped write the recommendations. 

Pav Kalsi, Diabetes UK senior clinical advisor, said: ‘We know that some people with diabetes may choose to use Lucozade as a hypo, when blood glucose levels are low, treatment. 

Lucozade and Ribena have been removed as suitable examples of a quick acting carbohydrate for the initial treatment for patients able to swallow 

Guidelines published by the Joint British Diabetes Societies for Inpatient Care

‘New products now contain approximately 50 per cent less sugar than before. This means you are likely to need to drink more to treat a hypo. 

‘It is possible that old and new recipes may appear on the shelf at the same time. Therefore it is vital that you check the label of your bottle to make sure you drink enough to treat a hypo. 

‘The guidance for adults recommends 15-20g of fast acting carbohydrate, like glucose, to effectively treat a hypo. 

‘There are a number of different treatment options for hypos, such as glucose tablets, and glucose gels, some of which can be prescribed. 

‘People with diabetes should consult their healthcare team for advice on the most effective hypo treatments.’

Lucozade Ribena Suntory (LRS), which manufactures the drinks, announced the ‘game-changing’ sugar reduction in November 2016.

It said all of its brands, including Orangina and V Energy, will contain less than 4.5g of sugar per 100ml by 2018. They will be replaced with low calorie sweeteners.

At the time it also said all packaging will be changed to ensure the nutritional information can clearly be seen on the front.

The move meant none of the brands will fall into the sugar tax category, which is set to come into effect next month.

A spokesperson for the company said: ‘We strongly recommend that consumers check the back of the pack to find out the nutritional information.

‘The decision to halve the sugar in our drinks is in response to the growing demand from consumers who now want healthier drinks.’

It added that diabetes organisations throughout the UK and Ireland and hospital trusts had been informed of the changes.  

WHAT IS THE SUGAR TAX?

The Government announced a sugar tax in their childhood obesity strategy to halve the number of overweight children by 2026.

The levy is expected to come into force in 2018 and will affect producers and importers of soft drinks that contain ‘added sugar’.

But after LRS’ change, all of its drinks will fall below the tax – which is aimed at products contain 5g of sugar or more per 100ml.

Hailed as a significant move in the step to combat childhood obesity, Oxford University scientists previously predicted that the move would work.

They calculated there will be 144,000 fewer cases of obesity among adults and children alike if the levy on sugar-laden soft drinks achieves its goals.

The sugar tax will be levied at 18p and 24p per litre depending on the level of sugar.

Drinks which contain 5g of sugar per 100ml attract the lower rate, while those with those with more than 8g per 100ml attract the higher rate. 

Pure fruit juices will be exempt from the levy as they do not carry added sugar, while drinks with a high milk content will also be exempt because of their calcium content.

Alcoholic drinks with an alcohol by volume of up to 1.2 per cent (ABV) are included in the levy, although some of these drinks will be exempt. 



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