What to know about hypoglycaemia in people with diabetes

Hypoglycaemia occurs when blood sugar falls too low for the body’s needs. It may follow too much insulin or certain diabetes medicines, a delayed or missed meal, extra physical activity, alcohol, illness or a change in routine.

Early signs can include shaking, sweating, hunger, a fast heartbeat, dizziness, irritability or difficulty concentrating. As it worsens, a person may become confused, drowsy, have a seizure or lose consciousness. Some people have reduced warning symptoms after repeated episodes.

If the person is awake and can swallow safely, take a fast-acting carbohydrate such as glucose tablets or a sugary drink, following the plan provided by their diabetes team. Check blood sugar again when advised, and once recovered, eat a snack or meal if the next one is not soon.

If episodes recur, record the timing, food, activity, medicine doses and symptoms for review. Do not change insulin or other medicines without clinical advice. Keep treatment available, tell close contacts what to do, and carry diabetes identification when away from home.

Call emergency services if the person is unconscious, having a seizure, severely confused, unable to swallow or does not improve after the agreed treatment. Do not put food or drink in an unconscious person’s mouth. Place them on their side if breathing normally, stay with them and follow the emergency operator’s instructions.

Ask what treatment to carry, how family or coworkers should respond, whether your medicines or meal plan need review, how exercise and alcohol affect your risk, and how to recognise episodes when warning symptoms are less noticeable.