Diabetes Services - Hypoglycaemia explained

What is a “hypo”?

Glucose is a sugar carried in the bloodstream that your body uses for energy. Your blood glucose levels can sometimes become too low.

This is called hypoglycaemia (or a “hypo”) and occurs when your blood glucose level drops below 4 mmol/L. Having a hypo means that your blood glucose level is too low.

What causes a hypo?

If you are injecting insulin or taking diabetes tablets that make your body produce more insulin, then you may be at risk of hypos.

• Too much insulin or too many diabetes tablets
• Incorrect insulin injection technique
• Delayed or missed meals
• Eating less starchy foods than usual
• Drinking too much alcohol or drinking alcohol without food
• Unplanned or strenuous physical activity

Symptoms?

Early signs and symptoms of a hypo include:

• Sweating
• Trembling and shaking
• Becoming pale
• Hunger

How to treat a hypo?

If you think you are having a hypo, first check that your blood glucose level is below 4mmol/L (with your blood glucose monitor). If it isn’t you do not need a hypo treatment.

If the blood glucose is below 4mmol/L, treat it immediately with something that will raise your blood glucose quickly. Suitable quick-acting glucose treatments to provide 15g to 20g carbohydrate are:

• A small carton (200ml) of smooth orange juice
• 6 dextrose tablets
• 5 standard jelly babies

If you do not feel better after 10 to 15 minutes (or your blood glucose level is still less than 4 mmol/L) repeat ONE of these treatments. When you start to feel better, and if you are not due to eat a meal, eat some starchy food, like 2 plain biscuits or a small banana. If you are not able to treat your hypo yourself, but you are still conscious and able to swallow, someone can give you glucose gel if you have this available.

How to avoid hypos

• Eat regularly and include a small portion of starchy carbohydrate at each meal, such as bread, rice or potatoes
• You may need to eat more carbohydrate before and after physical activity
• Keep to sensible alcohol limits and do not drink on an empty stomach
• Take your medication at the recommended dose and times
• Always carry glucose with you to treat hypos quickly

If you are concerned about anything within this leaflet, please discuss this with your healthcare professional.