Severe Hypoglycaemia

People with diabetes on insulin or certain diabetes tablets, may experience a low blood sugar level, usually called “Hypo”. Most often it is easily dealt with themselves with simple treatment. Sometimes, the person becomes confused or even unconscious and can’t help themselves. This is a serious or severe problem that requires urgent treatment.

Why does it happen?

Hypos have many causes but especially delaying food, extra physical activity or too much treatment. You may not have acted on the early warning signs of Hypo. You may not be testing yourself often enough especially at times of risk e.g. when you are late for food. You may not appreciate that a low blood test less than 4 mmol/l, and especially less than 3 mmol/l, should be treated as a Hypo even if you feel well. That’s because some people can not identify the early signs of a Hypo – called “Hypo unawareness”.

What should be done about it?

It is important to always carry your ID card or wear an identity bracelet so that strangers know what is wrong and what to do. It’s a good idea to tell the people you work with, your family and friends about your diabetes so they are aware that you may need their help in the future. If you have become confused and are unable to treat yourself it is important someone else knows what to do and can help you treat your Hypo.

If the person is conscious and is able to swallow safely without chocking. Give something high in sugar such as 3 or more glucose tablets (e.g. Dextrosol), or a small glass of lucozade / coke (not low calorie or diet versions), or two teaspoons of sugar. Honey, treacle, jam or Hypostop (a thick glucose gel) can be put into the side of the mouth and the cheeks massaged gently. It doesn’t need to be swallowed to work. If they are no better after 5 minutes, give some more. When they are better and able to eat safely without chocking, give a snack of food. Call 999 for an ambulance if at all worried.

If the person is unconscious. Place them in the “recovery position” lying flat on their side, head down. Never try to give food or drink by mouth because this can cause choking. Call 999 for an ambulance immediately. Inject Glucagon if it is available and someone present has been trained to do this. Never inject insulin. When conscious treat them as above.

Seeking advice and what care to expect

Occasional minor Hypos are a normal part of having diabetes. However, if you are experiencing regular Hypos or if you ever have a serious Hypo – always seek advice. Speak to your Diabetes Specialist Nurse or Doctor. They can teach you how to avoid the problem. They should also teach your family, friends or work mates what to do and how to use special treatments like Hypostop and Glucagon injections should you ever become unconscious as the result of a Hypo.