Hypoglycaemia is the term used for low blood sugar. It is also commonly referred to as a "Hypo".

Common Symptoms and Signs

Feeling hungry
Trembling
Sweating
Anxiety and irritability
Going pale
Pounding heart (palpitations) with rapid pulse
Tingling of the lips
Blurred vision
Difficulty in concentrating
Vagueness or confusion
Irrational behaviour

If left untreated, hypos may result in loss of consciousness.

Treatment of Mild Hypos

Take the simplest food containing carbohydrate that is quickly absorbed, such as lucozade or coke, three or more glucose tablets, etc. This should be followed with a longer acting carbohydrate snack.

Guidelines for self-treatment need to be flexible. Some people 'under treat' hypos in an effort to follow strict guidelines, while others 'over treat', resulting in rebound hyperglycaemia. People should be made aware that there is a delay of 10-15 minutes before treatment will raise blood glucose levels.

Treatment of Severe Hypos

If the person is unable to eat but is still conscious and able to swallow, put glucose gel (e.g. Hypostop), or jam, honey or treacle on inside of the cheeks and gently massage the outside of the cheeks.

If the person is unconscious, they should not be given anything by mouth as this can cause choking. If possible, they should be placed in the recovery position so the airway is not blocked.

Glucagon may be prescribed to people with diabetes in case of very severe hypos. It is important that instruction in its use is given to the person who is likely to administer the glucagon, not to the person with diabetes. Without their commitment and readiness to use it, it is pointless to prescribe glucagon.

Administration of glucagon may be simple from a healthcare professional perspective, with a range of injection site options, all equally effective. However, for the lay person it can be very daunting. Moreover, it is not risk free - eg people need to be aware of where to inject if injecting in the buttock (upper outer quadrant). Careful instruction is required. Carers should be careful to check the expiry date on their glucagon kit.

If the carer does not feel confident about administering glucagon, they should be encouraged to call an ambulance in an emergency and let them know that there is a person with diabetes who is unconscious.