Diabetes Symptom – Hypoglycaemia

Hypoglycaemia, or low blood sugar, occurs when blood glucose levels fall below 4 mmol/L (72 mg/dL). While primarily affecting people with diabetes who take insulin or certain diabetes medications, it can occasionally affect others. Understanding how to recognise and treat hypoglycaemia is crucial, as severe cases can be life-threatening.

Causes

Hypoglycaemia in people with diabetes typically occurs for several reasons:

• Taking too much insulin or diabetes medication
• Delaying or missing a meal
• Not eating enough carbohydrates
• Unplanned physical activity without adjusting medication or food intake
• Drinking alcohol without eating
• Some diabetes medications, particularly sulfonylureas

In rare cases, people without diabetes may experience hypoglycaemia due to:

• Certain medications
• Excessive alcohol consumption
• Critical illnesses (kidney, liver, or heart failure)
• Hormone deficiencies
• Insulinoma (insulin-producing tumour)
• Reactive hypoglycaemia (occurring within hours after meals)

Symptoms

Hypoglycaemia symptoms typically develop quickly and can include:

• Shakiness or trembling
• Sweating
• Hunger
• Fast heartbeat
• Anxiety or irritability
• Dizziness or lightheadedness
• Headache
• Confusion or difficulty concentrating
• Weakness or fatigue
• Blurred or impaired vision
• Slurred speech
• Tingling around the mouth

If blood sugar continues to drop, severe hypoglycaemia can cause:

• Seizures
• Loss of consciousness
• In rare cases, death

Treatment

Immediate treatment for mild to moderate hypoglycaemia follows the “15-15 rule”:

1. Consume 15 grams of fast-acting carbohydrates such as:
   • 4 glucose tablets
   • 1/2 cup (120ml) of fruit juice or regular soda
   • 1 tablespoon of honey or sugar
   • 8-10 jelly beans or gummy candies
2. Wait 15 minutes and check blood sugar again
3. If still below 4 mmol/L (72 mg/dL), repeat the process
4. Once blood sugar returns to normal, eat a small snack or meal if your next meal is more than an hour away

For severe hypoglycaemia (when a person is unconscious or unable to swallow safely):

• Do NOT give food or drink
• If available, administer glucagon injection (prescribed for people at risk)
• Call emergency services (000 in Australia, 911 in the US, 999 in the UK)
• Place the person in the recovery position if unconscious but breathing

Prevention

To prevent hypoglycaemia:

• Monitor blood glucose regularly
• Follow your meal plan and don’t skip meals
• Take medications exactly as prescribed
• Adjust medication before increased physical activity
• Carry fast-acting carbohydrates at all times
• Consider medical ID jewelry
• Educate family and friends about recognising and treating hypoglycaemia

If you experience frequent hypoglycaemia, speak with your healthcare provider about adjusting your diabetes management plan.