G_CS_32 Hypoglycaemia Recognition and Treatment Guidelines

Hypoglycaemia (hypo) is a medical term used for low blood glucose in people with diabetes treated with certain medication and occurs when the blood glucose reading is below 4.0mmols/l.

  • Hypos do NOT occur in those on diet or Metformin alone
  • Hypos may very between individuals
  • Causes of a hypo include :-
    • Less food than usual, Delayed or missed meals, Increased medication, Increased physical activity, A decrease in weight, Alcohol, Hot/ weather

Symptoms may include one or two of the following:-

  • Shaky / Dizzy, Sweaty, Anxious, Very Hungry, Confused, Tingling lips and fingertips, Headache or double vision

If the hypo is not treated at this stage it will go further and the patient will not be able to help themselves and will require help to take quick acting glucose.

Symptoms will then include:-

  • Slurred speech, Uncoordinated, Altered personality

Treatment for a hypoglycaemic attack is 15 to 20g of refined carbohydrate.

  • 2 teaspoons sugar or
  • 2 teaspoons honey or
  • 4 to 6 glucose, dextrose or Lucozade tablets or
  • 80 to 100ml Lucozade or
  • ½ can ordinary Coca cola

Then wait for 10 minutes and recheck blood glucose if still below 4mmol/l repeat refined carbohydrate, if after 3 times of refined CHO and 10 minute wait blood glucose still not rising may require IV Dextrose. Once above 4mmol/l give meal if it is due or CHO snack if not due e.g. fruit, biscuit, milky drink, or a sandwich. May then give insulin if it is due, do not omit insulin.  

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