1. INSULIN 2. MONITORING 3. HYPOS 4. SICK DAYS 5. MEDICATIONS 6. GLP-1RAs 7. NUTRITION Diabetes quick guides HYPOS Hypoglycaemia management What is a hypo? What are the common causes of hypo? Hypoglycaemia (also known as a hypo) occurs • Too much insulin or diabetes medication when your blood glucose levels (BGLs) drop too low. • Not enough carbohydrate in meal or snack Usually, a hypo is less than 4.0 mmol/L. • Extra (more than usual) activity or exercise For some people, for example the frail or elderly, • Alcohol a hypo may be less than 5.0 or 6.0 mmol/L. • Missed meal or fasting A hypo is a serious complication if not treated immediately. Reduced hypo awareness Why am I at risk of hypo? You may not always feel early warning signs and symptoms of a hypo. And over time you may feel You are at risk of hypo if you are taking a them even less. sulphonylurea (see Medications) or insulin. If your awareness of hypos reduces, you will need to monitor your BGLs very closely and regularly in What are the signs and order to be safe. symptoms of hypo? Driving Signs and symptoms can be very different for each person. Do not drive a vehicle if your BGL You may experience one or more of the following is less than 5.0 mmol/L. during a hypo: Check your BGL before you drive. 5.0mmol/L • trembling or shaking • feeling irritable Always take hypo treatment and your glucose meter • tingling • drowsiness or with you in the vehicle. • fast heartbeat weakness (palpitations) • dizziness The only sure way to know if you are • sweating • headache experiencing a hypo is to do a BGL check. • nausea • difficulty speaking. If you are feeling hypo symptoms and can’t • hunger check your BGL, treat the hypo regardless. • difficulty concentrating NOTE: This information is a guide only and does not replace individual medical advice. Diabetes quick guides This program is supported by funding from Tasmania PHN (Primary Health Tasmania) through the Australian Government’s PHN Program. Version 2.0 (July 2021) Page 1 of 3 Diabetes quick guides | HYPOS Hypo management plan Do not give food or fluid Make sure people around you – such as family, to an unconscious person. friends, work colleagues – know how to recognise and treat a hypo. If you use an insulin pump talk to your diabetes team about your hypo plan. If you are using CGM or Flash Treat with 15 grams of fast-acting Check GM, confirm your BGL sensor reading carbohydrate (glucose) with a finger prick check Fast-acting carbohydrates 15 grams GlucoJel™ 5 jellybeans Treat 15 grams Jellybeans (from fast-acting glucose pharmacy) Regular soft drink 150mL (not diet) Wait 15 minutes Lucozade® 100mL Oral glucose gel 1 tube Re-check your BGL Glucose tablets See product guide Above Below 4.0mmol/L 4.0mmol/L Follow up with 15 grams of slow-acting carbohydrate snack Treat 15 grams slow-acting carbohydrate OR meal with Slow-acting carbohydrates 15 grams carbohydrate Fresh fruit 1 medium piece (apple, banana) Bread or toast 1 slice Continue to Try to find out Talk to your check your what caused doctor or Milk 300mL BGLs regularly your hypo diabetes team Muesli bar 1 bar Call an ambulance if: • you vomit more than twice, or • you cannot eat or drink or • if your BGL is <4.0 mmol/L A meal that includes Pasta, rice, potato, after 2 treatments at least a quarter couscous, sweet plate of carbohydrate potato, bread, corn NOTE: This information is a guide only and does not replace individual medical advice. Diabetes quick guides This program is supported by funding from Tasmania PHN (Primary Health Tasmania) through the Australian Government’s PHN Program. Version 2.0 (July 2021) Page 2 of 3 Diabetes quick guides | HYPOS Glucagon Glucagon is a medication used to treat severe Important points about glucagon hypoglycaemia. A severe hypo is when you need • You cannot give glucagon yourself. A relative, someone else to treat your hypo – this is often friend or colleague must be trained to inject because you are too drowsy or it is unsafe to put glucagon. Make an appointment with a diabetes anything into your mouth. educator to arrange glucagon education. Glucagon is injected into muscle (usually your thigh). • Glucagon may not work if you have been fasting It works by releasing glucose stored in your liver or drinking alcohol. which raises your blood glucose levels quickly. • Always follow up by eating slow-acting Who needs glucagon? carbohydrate. A GP or NP will prescribe glucagon to you if you • Contact your GP or NP as soon as possible after are taking insulin and are at risk of severe hypo. you have used glucagon. Make sure your glucagon is in date. • Do not drive after using glucagon. Further resources Next steps Monitoring blood glucose NDSS (National Diabetes Services Scheme) Insulin – Parts 1 & 2 Contact the NDSS on 1800 637 700 Hyperglycaemia & to order printed copies, or visit sick day management ndss.com.au/about-diabetes/resources • Managing hypoglycaemia • Diabetes and driving: a quick guide & video (in English and other languages) Need help? • Baker IDI Fact Sheet Managing hypoglycaemia Phone 6215 9000 on an insulin pump or visit diabetestas.org.au NOTE: This information is a guide only and does not replace individual medical advice. Diabetes quick guides This program is supported by funding from Tasmania PHN (Primary Health Tasmania) through the Australian Government’s PHN Program. 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