Hypoglycaemia

What is Hypoglycaemia?

Hypoglycaemia or low blood glucose is a condition where the level of glucose (sugar) in the blood drops below a certain level (about 3.5mmol/l). This causes a number of symptoms that usually go away within 10 to 15 minutes after eating sugar.

Hypoglycaemia is more common in people who inject insulin, but it may also occur in people who take specific diabetes tablets for their diabetes.

What are the causes of hypoglycaemia?

Delaying or missing a meal
Not eating enough carbohydrate
More strenuous exercise than usual or unplanned physical activity
Alcohol
Too much insulin or medication.

Hypoglycaemia can cause some or all of the following symptoms:

headache
paleness
shaking
perspiration
a feeling of weakness
rapid heartbeat
hunger
agitation
difficulty concentrating
irritability
fatigue
blurred vision
tingling sensation around the mouth and lips.

If you feel any of the symptoms mentioned, test your blood glucose level. If this is not possible, treat as a hypo.

This is important because it will stop your blood glucose level from dropping even lower.

What is the treatment for a 'hypo'?

Step 1

Have some quick acting carbohydrate, such as:

½ can of ordinary soft drink
3 teaspoons sugar or honey
6 – 7 jelly beans
glucose tablets equivalent to 15 grams of carbohydrate

Test your blood glucose level.

Step 2

Follow Step 1 with some longer acting carbohydrate. This could be one of the following:

a sandwich
1 glass of milk or soy milk
1 piece of fruit
2 – 3 pieces of dried apricots or other dried fruit
1 tub of natural low fat yoghurt
6 small dry biscuits and cheese

Step 3

Wait 10 – 15 minutes. If you do not feel better, recheck your blood glucose level. If it has not risen, repeat Step 1.

It is very important to recheck your blood glucose level prior to driving.

What happens if it is not treated?

If a hypo is not treated quickly, the blood glucose level will continue to drop. This may result in:

temporary loss of consciousness
confusion
convulsions
coma

If a person loses consciousness, they can not be given food or drink.

Emergency treatment must be provided.

Place the person on their side making sure their airway is clear.
Dial 000 for an ambulance.
Give an injection of Glucagon* if available and if you are trained to give it.
Wait with the person until the ambulance arrives.

* Glucagon is a hormone, which is injected in a similar way to insulin. It is available on prescription from your doctor.

Other useful tips:

Carry quick acting carbohydrate with you if you are on insulin or certain types of medications. If you take Acarbose (Glucobay®) carry glucose tablets, glucose gel or Lucozade.
Wear identification such as a Medic Alert bracelet that says you have diabetes.
It is important that your family, friends and work colleagues know the symptoms of a hypo and how to help you with treatment, if required.
Test your blood glucose level before driving a motor vehicle.
If you drink alcohol, always eat carbohydrate at the same time.
Try to work out what has caused the hypo in an effort to avoid it happening again.
Record all episodes of hypoglycaemia in your diary and discuss these with your doctor or diabetes educator.