Can type 1 diabetes cause hypoglycaemia?

The pancreas makes little or no insulin in type 1 diabetes, so insulin is replaced with injections or a pump. A dose can become too much for the available carbohydrate if a meal is delayed, food is vomited, exercise is harder than expected, or alcohol is taken without food. Illness and changes in insulin absorption can also disturb the balance. Early signs include trembling, sweating, hunger, palpitations, irritability, dizziness or difficulty concentrating. Some people notice fewer warning signs after repeated episodes.

If you are awake and able to swallow, check your glucose if possible and follow your personal hypo plan using a fast-acting carbohydrate. Recheck as advised by your diabetes team, then eat a snack or meal if the next one is not soon. Do not take extra insulin to correct a low. Keep treatment with you, tell close contacts what to do, and review patterns with your diabetes team rather than changing doses alone.

Call emergency services if someone with suspected hypoglycaemia is unconscious, having a seizure, severely confused, or cannot swallow safely. Do not give food or drink to an unconscious person; place them safely on their side and use prescribed rescue medicine if trained. Seek prompt clinical advice for repeated lows, overnight episodes, or lows without warning symptoms.

Could my insulin, meals, exercise or illness explain this pattern? Should my dose, pump settings or glucose targets change? Should I have a glucagon rescue kit, and who should be trained to use it?