Hypoglycaemia in diabetes
What is hypoglycaemia?
Hypoglycaemia is a condition in which there is an abnormally low level of glucose (sugar) in the blood.
What causes hypoglycaemia?
This may occur from the over-secretion of insulin by the pancreas, too little glucose in the diet and, in the case of people with diabetes, an administration of too much insulin or too many diabetes tablets (or a combination of insulin and diabetes tablets) for the body's needs at that time. Diabetic hypoglycaemia may occur if the person accidentally injects too much insulin, misses a meal, drinks alcohol, especially on an empty stomach, or undertakes much more strenuous exercise than they are used to without compensating by eating extra food.
What are the symptoms of hypoglycaemia?
In most cases there are recognisable symptoms of diabetic hypoglycaemia and you can then take appropriate remedial action. However, in some circumstances, for example, during sleep, warning symptoms are not always recognised and the appropriate action is not taken, which may result in the person becoming unconscious. Also, some medications, such as beta-blockers which are used to treat high blood pressure, can hide some of the symptoms of hypoglycaemia, making it more difficult to detect. If the person is aware of the onset of hypoglycaemia they can take steps to counteract it.
The first symptoms of hypoglycaemia in diabetes
Hypoglycaemia causes the body to release adrenaline, which causes the first symptoms to appear. These first symptoms often include:
- sweating;
- trembling or shaking;
- pounding of the heart;
- anxiety;
- weakness;
- numbness around the lips; and
- hunger.
Other symptoms of hypoglycaemia
Hypoglycaemia also starves the brain of the glucose energy needed for correct brain functioning, and this lack of glucose can cause many other symptoms, including:
- light-headedness or dizziness;
- headache;
- mental confusion and abnormal behaviour;
- drowsiness;
- speech difficulty;
- irritability;
- lack of co-ordination;
- loss of consciousness;
- seizure; and
- coma.
These symptoms can occur at different levels of blood glucose in different people and severe hypoglycaemia can result in death.
Care in hypoglycaemic episodes
It is important to be aware of the symptoms which show that your blood sugar is getting too low as not everyone has all the symptoms.
Because hypoglycaemia may cause symptoms such as slurred speech and lack of co-ordination, it is important for a person with diabetes to wear a MedicAlert bracelet or ID so that people know they have diabetes and their condition is recognised as hypoglycaemia. It has happened that people having hypoglycaemic episodes have been thought to be drunk and treatment has not been given, resulting in coma.
In cases of hypoglycaemic coma the person may have convulsions, so care must be taken to ensure that they do not hurt themselves. There is also a risk of brain damage during these convulsions.
What to do if you feel hypoglycaemic
Quickly take 10–15 g of a simple (quick acting, easily digested) carbohydrate to boost your blood sugar — for example, 3 teaspoons/cubes of sugar, some glucose tablets (usually 2 or 3), a sweetened drink such as half a can of regular (not diet) soft drink, Lucozade or orange juice, 6-7 jellybeans or 3 teaspoons of honey. Always carry some emergency glucose sources with you and keep some at work and in your car.
Your symptoms should improve within 10-15 minutes and you should start to feel better. If symptoms persist, take another 10-15 g of a simple carbohydrate. If it will be more than 20 minutes before your next main meal, eat some long-acting carbohydrate such as a sandwich, a glass of milk or soy milk, or 2 or 3 dried apricots or other pieces of dried fruit.
If a hypoglycaemic person does not improve and progresses to being drowsy, having convulsions, or passes into a coma, it is a medical emergency. If you have been trained to administer glucagon, do so. Otherwise, you should dial 000 immediately and say that it is a ‘diabetic emergency’.
Never give food or drink to a person who cannot swallow properly, for example, if they are drowsy, having a seizure or unconscious.
Last Reviewed: 07 September 2009
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