1. HYPOGLYCAEMIA AND TREATMENTS
Community Diabetes Specialist Nurses
Nottingham CityCare Partnership

2. WHAT IS A HYPOGLYCAEMIA

3. WHEN GLUCOSE LEVELS DROP
HYPOGLYCAEMIA
(HYPO)
WHEN GLUCOSE LEVELS DROP
USUALLY BELOW 4MMOLS

4. WHY DOES HYPOGLYCAEMIA
OCCUR?

5. Missed or late meals
Eating less carbs than usual
Too much insulin
Too much sulphonylurea
More activity than usual e.g
gardening, shopping, golf,
walking, dancing

6. Injecting muscle
instead of
the fatty layer
under the skin
Excessive alcohol consumption
Extremes in
temperature
Stress and illness

7. Consider If Hba1c is less than 48 mmol/mol Overtreatment of medication
Increase risk of Hypoglycaemia

8. Common Symptoms of Hypo
Sweating
Dizziness
Trembling
Tingling hands, feet, lips and tongue
Hunger
Anxiety
Irritability
Palpitations

9. If not treated quickly the symptoms of hypo become more severe
Coordination may suffer
Vision can become blurred
Behaviour can become irrational and erratic, even aggressive
If the hypo sufferer refuses help this needs to be ignored as the effects
of the hypo are causing them to react in an irrational way

10. Game

11. Treatment of a Hypo MILD to MODERATE
7 Dextrosol energy tablet or 5 Glucotabs
Sweet drink (200mls)– pure fruit juice, fizzy pop (not diet), lucozade
(amount can vary depending on type)
3-4 Jelly Babies
1 tube of Glucogel
Each has approximately 15-20g of carbohydrate
CHECK GLUCOSE AFTER 10 MINUTES AND REPEAT IF STILL LOW
DO NOT USE THESE TREATMENTS FOR SOMEONE WHO IS UNABLE TO
SWALLOW OR UNCONSCIOUS

12. SEVERE HYPO
This is where the patient is unable to react ‘normally’ to a situation … they
may not be completely still and silent
GLUCAGON
Glucagon is a hormone (like insulin) also made by the pancreas but has
the opposite effect of insulin. It raises the glucose level in the blood
Available in the UK on prescription:
GlucaGen Hypo Kit
Comes as a vial of powder and syringe of water which is mixed just before
injecting
IF GLUCOGEN IS NOT AVAILABLE IN THIS SITUATION A 999 AMBULANCE
NEEDS TO BE CALLED.

13. After a Hypo
Is Normal to feel
Emotional
Headachy
Nauseous

14. Following a Hypo Once the patient has started to recover from the hypo
If their meal is due they can have this.
If it is a while until their next meal 1 slice of medium bread or toast or 2 digestive
biscuits. These are approximately 15-20g of carbohydrate
Patient will need reassuring as it can be a very frightening experience.

15. If next insulin injection is due following a severe hypo it would be wise to delay this until patient is fully recovered
The Insulin or Sulphonylurea doses will need reviewing
Consider why the hypo happened

16. HYPOGLYCAEMIA AND DRIVING

17. DVLA changes to driving and using insulin
DVLA must be informed - 3yr driving licence
New rules brought in end of Group 2 drivers ( lorry
and bus drivers) can now use insulin
Testing before driving – 5 to drive – then every 2hrs. Carry
testing kit and hypo treatment always
Sulphonylureas
If hypo while driving what do you advise?
Informing DVLA of any severe hypos – 2 in 1yr licence will
be revoked - 1 in 1yr for Group 2 drivers