Hypoglycaemia: what to do when sugar drops

What is hypoglycaemia?

A fall in blood sugar below 50 mg/dl (3 mmol/l) is called hypoglycaemia. Anyone who skips a meal may feel hunger, headache, weakness and dizziness. In people with diabetes, however, hypoglycaemia is more severe and, if not corrected in time, can lead to a hypoglycaemic coma.

What are the signs?

• sudden intense hunger;
• weakness, tiredness;
• trembling, cold sweat;
• a racing heartbeat;
• unexplained fear;
• pale skin;
• blurred vision;
• numbness of the tongue and lips;
• in severe cases – confusion, seizures and loss of consciousness.

Why does blood sugar drop?

In people with diabetes, the main causes of hypoglycaemia are:

• taking too much insulin or glucose-lowering medication;
• taking medication at the wrong time;
• skipping a meal after taking medication, eating at irregular times;
• eating too little carbohydrate with a meal;
• more physical activity than usual;
• drinking alcohol;
• changing the insulin injection site;
• digestive problems, delayed stomach emptying;
• moving from a cold environment into a very hot one;
• the start of a menstrual period in women.

First aid: if the person is conscious

1. Help the person into a comfortable position – sitting or lying down.
2. Give fast-acting sugar straight away: 2 sugar cubes, a little honey, sugared water or a sweet biscuit. Sweeteners do not help in this situation.
3. Once they feel better, give porridge, a slice of bread or a piece of fruit.
4. Let them rest until their condition returns to normal.
5. If a glucose meter is available, recheck blood sugar after a while; if there is no improvement, repeat the sugary food.
6. If the symptoms do not go away or get worse, call an ambulance.

First aid: if the person is unconscious

1. Call an ambulance immediately.
2. Lay the person on their side – they may vomit.
3. Do not put food or drink into their mouth.
4. If glucagon is available, it should be injected into a muscle.
5. Monitor breathing and pulse, and be ready to start chest compressions and rescue breaths if needed.

How can it be prevented?

Regular meals are especially important for people with diabetes: snacks between meals prevent long gaps without food and hypoglycaemia, ease hunger until the next main meal and help avoid overeating. A snack should come about 2–2.5 hours after a main meal and combine carbohydrate with protein, for example:

• fruit and almonds;
• wholegrain crackers and milk;
• a cheese sandwich;
• nuts and ayran (a yoghurt drink).