What Is Hypoglycaemia and How Do You Treat a Hypo?

A sudden shake. A wave of sweat. Feeling hungry, dizzy or strangely irritable. Sometimes, your body can tell you that your blood glucose is dropping before you even have a chance to check it.

This is known as hypoglycaemia, often called a “hypo” or a “low”. Hypoglycaemia is an abnormally low level of glucose in our blood (blood glucose below 4.0 mmol/L).

Hypoglycaemia is most commonly associated with people who use insulin or certain types of glucose-lowering medication. It can happen for several reasons, including changes in food, physical activity, medication, alcohol consumption or illness.

A hypo can sometimes happen without obvious warning, and symptoms can vary from person to person. Learning your own early warning signs can help you recognise a low before it becomes more serious.

Why does hypoglycaemia happen?

There isn't always one simple reason for a hypo. However, some situations can make low blood glucose more likely.

These can include:

• Missing or delaying a meal
• Not eating enough carbohydrate for the amount of insulin or medication being used
• Unexpected or strenuous physical activity
• Taking more insulin or certain diabetes medicines than needed
• Drinking alcohol, particularly without eating
• Changes to your usual eating, exercise or medication routine

Insulin and some other diabetes medicines can increase the risk of hypoglycaemia because they lower blood glucose.

If you experience frequent hypos, it's worth discussing them with your doctor, diabetes educator or other diabetes healthcare professional. They may be able to help identify patterns and review your diabetes management plan.

What does hypoglycaemia feel like?

Everyone can experience a hypo differently, and your symptoms may change over time.

Early symptoms of a hypo can include:

• Shaking or trembling
• Sweating
• Feeling hungry
• Dizziness or light-headedness
• Feeling tired or weak
• A fast or pounding heartbeat
• Tingling or numbness around the lips or face
• Irritability or changes in mood
• Feeling anxious or tearful
• Pale skin
• Difficulty concentrating

These symptoms can be your body's early warning signs that your blood glucose is too low.

What happens if a hypo becomes more severe?

If hypoglycaemia is not treated, blood glucose can continue to fall and symptoms may become more serious.

These can include:

• Blurred vision
• Confusion
• Difficulty concentrating
• Changes in behaviour
• Poor coordination or clumsiness
• Slurred speech
• Drowsiness
• Seizures
• Loss of consciousness

Severe hypoglycaemia requires urgent medical attention.

How do you treat hypoglycaemia?

If you are experiencing symptoms of a hypo and can safely swallow, treat it promptly with fast-acting carbohydrate.

For most people, Australian diabetes guidance recommends around 15 g of fast-acting carbohydrate.

Step 1: Have fast-acting carbohydrate

Choose something that contains approximately 15 g of carbohydrate and is quickly absorbed.

Examples include:

• Glucose tablets or gel containing approximately 15 g carbohydrate. like Gluclogy fast-acting Glucochews. 
• 6–7 regular jellybeans
• ½ a can (150 mL) of regular soft drink (not diet or sugar-free)
• ½ a glass (125 mL) of fruit juice
• 3 teaspoons of sugar or honey

The exact amount and type of treatment that is right for you can vary. If you use an insulin pump or have an individual hypo plan, follow the instructions provided by your diabetes healthcare team.

Step 2: Recheck your blood glucose

Wait around 10–15 minutes, then check your blood glucose again.

If it is still below 4.0 mmol/L, have another 15 g of fast-acting carbohydrate ( Gluclogy fast-acting Glucochews) and check again after another 10–15 minutes.

If you cannot check your blood glucose but you have symptoms that suggest a hypo, Australian guidance advises treating the suspected hypo rather than delaying treatment.

Step 3: Consider longer-acting carbohydrate

Once your blood glucose is above 4.0 mmol/L, you may need some longer-acting carbohydrate to help maintain your blood glucose level — particularly if your next meal is more than around 15–20 minutes away.

Examples include:

• A slice of bread
• A piece of fruit
• A glass of milk
• A small tub of fruit yoghurt
• Dried fruit

If your next meal is due soon, your usual meal may provide the carbohydrate you need. Not everyone needs a follow-up snack, so your healthcare professional can help you determine what is appropriate for you.

What can you use to treat a hypo?

When treating hypoglycaemia, the goal is to have fast-acting carbohydrate that can be consumed quickly and safely. Australian guidance commonly recommends around 15 g of fast-acting carbohydrate for most people, followed by a blood glucose check after 10–15 minutes.

There are several ways to get this carbohydrate. The best option can depend on where you are, what you have available and what fits into your diabetes management routine.

What should you do if someone is having a severe hypo?

This is one of the most important things to know, particularly if you live with someone who uses insulin or medicines that can cause hypoglycaemia.

If someone is very drowsy, unconscious, having a seizure or unable to swallow safely, do not give them food, drink or glucose by mouth.

Instead:

1. Call 000 for an ambulance.
2. Put the person into the recovery position if appropriate.
3. Do not attempt to feed or give them anything to drink.
4. If they have a glucagon treatment prescribed for them and you have been trained to use it, follow the instructions provided.
5. Stay with them until emergency help arrives.

Giving food or drink to someone who cannot swallow safely could cause choking. Healthdirect specifically recommends calling 000 for someone who is unconscious or drowsy and not giving them anything by mouth.

How can you prepare for a hypo?

You can't always predict when a hypo will happen, but you can make treatment easier by being prepared.

Keep fast-acting carbohydrate nearby

Consider keeping hypo treatment in places where you spend time, such as:

• Your handbag or backpack
• Work
• Your bedside table
• Your car
• Your gym bag
• Your travel bag

NDSS recommends having a hypo kit containing a blood glucose meter and supplies, fast-acting carbohydrate and, where appropriate, longer-acting carbohydrate.

Make sure the people around you know what to do

If you experience hypoglycaemia, consider explaining to family, friends, colleagues or other trusted people:

• What your hypo symptoms look like
• Where you keep your hypo treatment
• How to help you if you become confused
• When they should call 000

This can be particularly useful for people who experience severe hypos or may have difficulty recognising their own symptoms.

Check expiry dates

If you keep hypo treatments in different locations, check them regularly and replace anything that has expired or been used.

Having treatment nearby only helps if it is actually available when you need it.

A simple way to remember hypo treatment

When you're feeling shaky or confused, remembering several steps can be difficult.

A simple approach is the following 5 steps:

1. Treat: Have around 15 g of fast-acting carbohydrate.
2. Wait: Give it around 10–15 minutes.
3. Check: Recheck your blood glucose.
4. Repeat: If it is still below 4.0 mmol/L, repeat the fast-acting carbohydrate treatment.
5. Follow up: Once your blood glucose is above 4.0 mmol/L, consider longer-acting carbohydrate if your next meal is not soon.

Your own diabetes management plan may differ, so follow the advice given to you by your healthcare team.

Glucochews: a portable option for fast-acting glucose

Having a measured source of fast-acting glucose within easy reach can make it simpler to carry hypo treatment with you.

Glucology Glucochews contain 3.8 g of glucose per chew and are designed as a portable fast-acting glucose option. Four Glucochews provide approximately 15.2 g of glucose, which is close to the 15 g amount commonly recommended for treating a hypo.

They are available in Raspberry, Orange and Lime flavours and can be kept in places such as a handbag, desk, bedside table or gym bag.

However, always follow your own hypo management plan and the advice of your diabetes healthcare professional, particularly if you have been advised to use a different amount of carbohydrate.

To make food logs more seamless and easier to document, check out our smart nutrition scale that comes with an integrated food diary app.

Know your signs and have a plan

Hypoglycaemia can happen quickly, but knowing your symptoms and having fast-acting carbohydrate available can help you respond promptly.

Know when a hypo has become an emergency. If someone is unconscious, very drowsy, having a seizure or unable to swallow safely, do not give them anything by mouth, call 000.

If you are experiencing frequent or severe hypos, speak with your diabetes healthcare team. You don't have to work out the pattern alone.

Explore our blog for more tips and resources on diabetes management.

Disclaimer: This blog is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your doctor or a qualified health provider with any questions about your condition. If you have a medical emergency, call 911 (US) or 000 (Australia) immediately, or visit your nearest emergency care center.