How is hypoglycaemia different in people with diabetes?

Insulin and some other diabetes medicines can lower blood glucose more than intended when a meal is delayed, less food is eaten, alcohol is taken, or activity is harder or longer than planned. Illness and changes in routine can also disturb usual patterns. Early signs may include sweating, shaking, hunger, tingling, palpitations, anxiety, dizziness or irritability. If the episode progresses, concentration, speech, behaviour and consciousness can change. Some people notice fewer warning signs after repeated episodes.

Check glucose if a meter or sensor is available, but do not delay treatment when typical symptoms are strong. If the person is awake and can swallow safely, take a fast-acting sugary drink or glucose product according to their personal diabetes plan, then recheck and repeat the plan if symptoms continue. Once recovered, eat a longer-lasting carbohydrate if the next meal is not soon. Record the episode and review possible triggers with the diabetes team.

Call emergency services if the person has a seizure, is unconscious, cannot swallow safely, or does not recover promptly. Do not put food, drink or tablets in an unconscious person's mouth. Place them on their side, check breathing and use prescribed rescue glucagon if someone trained to give it is present. Repeated episodes, night-time episodes or reduced warning symptoms need prompt clinical review even if each episode resolves.

Ask whether medicine doses, meal timing, exercise planning or alcohol advice need changing, how to use your glucose device, and whether you should carry a treatment kit or rescue medicine.