Hypoglycemia is defined by the development of autonomic or
neuroglycopenic symptoms; a low plasma glucose (PG) level
(<4.0 mmol/L for people with diabetes treated with insulin or an
insulin secretagogue; and symptoms responding to the administration of
carbohydrate. Hypoglycemia is most frequent in people with type 1
diabetes, followed by people with type 2 diabetes managed by insulin,
and people with type 2 diabetes managed by sulfonylureas.
Hypoglycemia can cause a range of symptoms including confusion,
trembling, sweating, increased heart rate, difficulty with
concentration and speech, and in severe cases can lead to a seizure or coma.2-4
People with diabetes who experience recurrent
hypoglycemia or severe hypoglycemia may be at an increased risk of
cardiovascular complications, such as strokes and heart attacks.5
2. Seaquist ER, Anderson J, Childs B, et al. Hypoglycemia and
diabetes: a report of a workgroup of the American Diabetes
Association and the Endocrine Society. Diabetes Care.
Everyone reacts differently to low blood sugar. If you have a friend
or family member living with diabetes you might spot these warning signs:
In addition, if you’re living with diabetes yourself, low blood
sugar might also make you feel:
Lightheaded or dizzy
Blurry or impaired eyesight
Tingling or numbness in
lips/tongue or cheeks
Weak or no
It’s important to increase low blood sugar straight away when it happens.
What should I do when I or someone with diabetes has low blood sugar?
A hypo can develop into a serious situation if it's not treated. So,
if you think you’re having a hypo – act promptly.
Treating yourself 8,9
The goals of treatment for hypoglycemia are to detect and treat a
low BG level promptly by using an intervention that provides the
fastest rise in BG to a safe level, to eliminate the risk of injury
and to relieve symptoms quickly.
It is also important to avoid over-treatment since this can result
in rebound hyperglycemia and weight gain. Evidence suggests that 15 g
glucose (monosaccharide) is required to produce an increase in BG of
approximately 2.1 mmol/L within 20 minutes.
Examples of 15 g of carbohydrate for the treatment of
mild-to-moderate hypoglycemia include:
15 g of glucose in
the form of glucose tablets
15 mL (3 teaspoons) or 3
packets of table sugar dissolved in water
5 cubes of
150 mL of juice or regular soft drink
Savers™ (1 = 2.5 g of carbohydrate)
15 mL (1 tablespoon)
Additional recommendations include:
If you’re currently using or
starting therapy with insulin or insulin secretagogues, it’s best
to be counselled with your support persons on hypoglycemia.
Speak with your healthcare provider at each visit to
understand the cause, frequency, symptoms, recognition, severity
and treatment of hypoglycemia.
If you have an increased
risk of hypoglycemia, avoid pharmacotherapies associated with
increased risk of recurrent or severe hypoglycemia, and increased
frequency of SMBG.
If you have recurrent or severe
hypoglycemia, or impaired awareness of hypoglycemia, reduce your
risks through less stringent glycemic targets, CSII or CGM or
sensor augmented pump with education and follow up for type 1
Severe hypoglycemia in a conscious person with
diabetes should be treated by oral ingestion of 20 g carbohydrate,
preferably as glucose tablets or equivalent.
hypoglycemia has been reversed, you should have the usual meal or
snack that is due at that time of the day to prevent repeated
hypoglycemia. If a meal is >1 hour away, a snack (including
15 g carbohydrate and a protein source) should be consumed.
If you are at risk of severe hypoglycemia, your support
persons should be taught how to administer glucagon.